Healthcare Provider Details

I. General information

NPI: 1942035217
Provider Name (Legal Business Name): MR. DAJEAN D CHANEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41430 GRAND RIVER AVE STE D
NOVI MI
48375-1876
US

IV. Provider business mailing address

41430 GRAND RIVER AVE STE D
NOVI MI
48375-1876
US

V. Phone/Fax

Practice location:
  • Phone: 844-900-2630
  • Fax:
Mailing address:
  • Phone: 844-900-2630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: