Individual
HENRIETTA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4729 GRAND CYPRESS CT, RALEIGH, NC 27604-5877
(919) 272-2594
(919) 272-2594
Mailing address
4729 GRAND CYPRESS CT, RALEIGH, NC 27604-5877
(919) 272-2594
(919) 272-2594
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NC
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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