Organization
JOHNSONVILLE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY L JOHNSON (OPERATOR)
(913) 371-3995
Entity
Organization
Contact information
Practice address
2419 N 22ND ST, KANSAS CITY, KS 66104-4612
(913) 371-3995
(866) 372-9403
Mailing address
2419 N 22ND ST, KANSAS CITY, KS 66104-4612
(913) 371-3995
(866) 372-9403
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
B105114
KS
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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