Organization
TONYA JOHNSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA ALICIA JOHNSON (OWNER)
(352) 857-4223
Entity
Organization
Contact information
Practice address
15260 NW 29TH TER, REDDICK, FL 32686-3332
(352) 857-4223
Mailing address
15260 NW 29TH TER, REDDICK, FL 32686
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906898
FL
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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