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Organization

COULSANDER JOHNSON CONCERN GERIATRIC CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS COULSANSER JOHNSON LVN (LVN)
(562) 230-3354
Entity
Organization

Contact information

Practice address
539 E RHEA ST APT 4, LONG BEACH, CA 90806-5542
(562) 212-6835
Mailing address
2090 MYRTLE AVE, LONG BEACH, CA 90806-4932
(562) 230-3354

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
253Z00000X
In Home Supportive Care Agency
Primary
311ZA0620X
Adult Care Home Facility
VN192615
CA
385H00000X
Respite Care

Other

Enumeration date
05/09/2013
Last updated
12/19/2019
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