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1104174085
JOHNNIE LEGRANT LEE
MINNEAPOLIS, MN
NPI
1104174085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
(Licence: MN 270227392)
Enumeration Date
2012-08-26
Last Update Date
2012-08-26
Business Address
Mr. JOHNNIE LEGRANT LEE
4347 4TH AVE S
MINNEAPOLIS, MN 55409-2115
Phone number: 612-823-3880
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Mailing Address
Mr. JOHNNIE LEGRANT LEE
4347 4TH AVE S
MINNEAPOLIS, MN 55409-2115
Phone number: 612-823-3880
Copy
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