Individual
RICHARD E. JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2030 KIPLING DR, DAYTON, OH 45406-3822
(937) 991-0047
Mailing address
2030 KIPLING DR, DAYTON, OH 45406-3822
(937) 991-0047
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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