Organization
JAN JOHNSON
Active
Other names
First Step
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAN J JOHNSON LADC (DIRECTOR)
(218) 894-0034
Entity
Organization
Contact information
Practice address
201 6TH ST NE, STAPLES, MN 56479-2431
(218) 894-0034
Mailing address
518 2ND AVE NE, STAPLES, MN 56479-2930
(218) 894-2412
(218) 894-0034
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1039408-1-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
437100000
MHCP
MN
Enumeration date
05/14/2007
Last updated
07/16/2008
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