Organization
JOHNSON ENRICHMENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARENCE E JOHNSON III BA, QP (CEO)
(336) 705-5786
Entity
Organization
Contact information
Practice address
221 FOXCROFT DR, WINSTON SALEM, NC 27103-5313
(336) 705-5786
Mailing address
221 FOXCROFT DR, WINSTON SALEM, NC 27103-5313
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
12/16/2020
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