# THE SUGGAH SHACK HEALING FARM & MARKET, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE SUGGAH SHACK HEALING FARM & MARKET, LLC
- **Other names:** Suggah Shack Midwifery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1497594063
- **Legal business name:** THE SUGGAH SHACK HEALING FARM & MARKET, LLC
- **Authorized official:** JAYVON MUHAMMAD L.M., C.P.M. (OWNER)
- **Authorized official phone:** (415) 244-7901

## Contact information

- **Practice address:** 19496 RAOUL RD, IOWA, LA 70647-6716
- **Practice address phone:** (415) 244-7901
- **Mailing address:** 19496 RAOUL RD, IOWA, LA 70647-6716
- **Mailing address phone:** (415) 244-7901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | NULL | Yes |
| 176B00000X | Midwife | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2024
- **Last updated:** 05/22/2024