# RONALD R. JOHNSON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Underwood Manor LLHCSA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013125467
- **Authorized official:** MR. RONALD RAY JOHNSON (OWNER)
- **Authorized official phone:** (716) 595-8784

## Contact information

- **Practice address:** 4460 UNION HILL RD, HINSDALE, NY 14743-9715
- **Practice address phone:** (716) 557-2322
- **Mailing address:** 2063 ROUTE 83, FORESTVILLE, NY 14062-9639
- **Mailing address phone:** (716) 965-2644
- **Mailing address fax:** (716) 965-4163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 0671A003 | NY | Yes |

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 08/22/2020