Organization
GEM INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHESIAS JOHNSON (ADMINISTRATOR/OW ER)
(310) 749-5563
Entity
Organization
Contact information
Practice address
700 E 80TH ST, LOS ANGELES, CA 90001-3210
(310) 720-7165
Mailing address
300 LONG BEACH BLVD UNIT 21139, LONG BEACH, CA 90801-7168
(310) 749-5563
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251T00000X
PACE Provider Organization
—
—
310400000X
Assisted Living Facility
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
01/17/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us