D & J Home Care, Inc.

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

License

AL740304792 Issued in MI

Legal business name

D & J HOME CARE, INC.

Practice address

5485 Smiths Creek Rd
Kimball, MI 48074-3811

Phone

(810) 367-7192

Fax

(810) 367-4308

NPI assigned

Oct 22, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shella Faye Minor

Title

Administrator

Phone

(586) 383-4404

Specialties & licenses 3

Addresses

Other names 1

• Wadhams Creek Senior Community Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1043614852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5485 SMITHS CREEK RD",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480743811",
            "telephone_number": "810-367-7192",
            "fax_number": "810-367-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5485 SMITHS CREEK RD",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480743811",
            "telephone_number": "810-367-7192",
            "fax_number": "810-367-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D & J HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "MINOR",
        "authorized_official_first_name": "SHELLA",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "586-383-4404",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "MI",
            "license": "AL740304792",
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "MI",
            "license": "AS740308018",
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "MI",
            "license": "AS740299147",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wadhams Creek Senior Community",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Myrna Bautista Booth, RDH
• Frank Paul Brettschneider, DDS
• Yvette Rene Caldwell, LMSW
• Shannon K Carter, RDH
• Gail Ann Cookingham, MD
• Leah Dansby
• Michele Dickenson, LPN
• Ehardts Advanced Care Pharmacy
• Sanaa Elghalmi
• Scott J. Ferguson, D.D.S.

• All providers in Kimball, MI
• Assisted Living Facility (Behavioral Disturbances) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.