Individual
LASANDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5750 GATEWAY DR, INDIANAPOLIS, IN 46254-2849
(844) 677-4300
Mailing address
5750 GATEWAY DR, INDIANAPOLIS, IN 46254-2849
(844) 677-4300
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
017065
IN
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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