Provider Demographics
NPI:1568804730
Name:DAJ HOME HEALTH CARE
Entity Type:Organization
Organization Name:DAJ HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-518-4432
Mailing Address - Street 1:24123 GREENFIELD RD
Mailing Address - Street 2:110
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3125
Mailing Address - Country:US
Mailing Address - Phone:214-518-4432
Mailing Address - Fax:
Practice Address - Street 1:24123 GREENFIELD RD
Practice Address - Street 2:110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3125
Practice Address - Country:US
Practice Address - Phone:214-518-4432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service