Provider Demographics
NPI:1649733635
Name:DUTTON FARM, INC
Entity type:Organization
Organization Name:DUTTON FARM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FELMLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-608-4173
Mailing Address - Street 1:2290 DUTTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-2332
Mailing Address - Country:US
Mailing Address - Phone:248-608-4173
Mailing Address - Fax:
Practice Address - Street 1:2290 DUTTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-2332
Practice Address - Country:US
Practice Address - Phone:248-608-4173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services