| NPI | 1184203010 |
|---|---|
| Doing Business As | JOHNSON'S FUNCTIONAL VILLAGE, LLC |
| Entity Type | Organization |
| Authorized Contact | KATTIA-NYDE CHAMPAGNE JOHNSON Occupational Therapist 256-299-5380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |