Individual
MR. ALVIN EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B/S CRIMINAL JUSTICE
Contact information
Practice address
9003 BARNETT AVE., KANSAS CITY, KS 66112
(913) 486-0472
Mailing address
9003 BARNETT AVE., KANSAS CITY, KS 66112
(913) 486-0472
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/03/2011
Last updated
12/21/2011
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