Provider Demographics
NPI:1578104584
Name:JMM ENTERPRISES
Entity Type:Organization
Organization Name:JMM ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-285-2559
Mailing Address - Street 1:313 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-2003
Mailing Address - Country:US
Mailing Address - Phone:517-925-8375
Mailing Address - Fax:
Practice Address - Street 1:313 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-2003
Practice Address - Country:US
Practice Address - Phone:517-925-8375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JMM ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty