Healthcare Provider Details

I. General information

NPI: 1922874452
Provider Name (Legal Business Name): J & M FAMILY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 WADSWORTH AVE
SAGINAW MI
48601-1624
US

IV. Provider business mailing address

1517 WADSWORTH AVE
SAGINAW MI
48601-1624
US

V. Phone/Fax

Practice location:
  • Phone: 989-522-0764
  • Fax:
Mailing address:
  • Phone: 989-522-0764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMISE MITCHELL
Title or Position: OWNER
Credential:
Phone: 989-522-0764