Individual
M CHRISTINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16203 COUNTY ROAD 19, FORT MORGAN, CO 80701-7134
(970) 370-1649
Mailing address
16203 COUNTY ROAD 19, FORT MORGAN, CO 80701-7134
(970) 370-1649
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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