Individual
KIMA LASHAWN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2703 38TH ST NW APT H, CANTON, OH 44709-2051
(330) 309-3509
Mailing address
1921 ROYAL AVE NE, CANTON, OH 44705-2247
(330) 309-3509
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
RN01005
OH
332U00000X
Home Delivered Meals
RN010005
OH
343900000X
Non-emergency Medical Transport (VAN)
RN010005
OH
347C00000X
Private Vehicle
RN010005
OH
376J00000X
Homemaker
RN010005
OH
385H00000X
Respite Care
Primary
RN010005
OH
385HR2050X
Respite Care Camp
RN01005
OH
385HR2055X
Child Mental Illness Respite Care
RN010005
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
RN010005
OH
385HR2065X
Child Physical Disabilities Respite Care
RN010005
OH
Other
Enumeration date
05/19/2023
Last updated
09/18/2023
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