Provider Demographics
NPI:1679025886
Name:DDJ, LLC
Entity Type:Organization
Organization Name:DDJ, LLC
Other - Org Name:FIRST LIGHT HOME CARE OF BIRMINGHAM AND OVER THE MOUNTAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS DEVELOPMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-390-1999
Mailing Address - Street 1:2112 11TH AVE S
Mailing Address - Street 2:STE 528
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2816
Mailing Address - Country:US
Mailing Address - Phone:205-390-1999
Mailing Address - Fax:
Practice Address - Street 1:2112 11TH AVE S
Practice Address - Street 2:STE 528
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2816
Practice Address - Country:US
Practice Address - Phone:205-390-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care