| NPI | 1710675640 |
|---|---|
| Doing Business As | NEDRA JOHNSON |
| Entity Type | Organization |
| Authorized Contact | NERDRA JOHNSON CEO 214-280-0379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 251T00000X PACE Provider Organization | |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-04-27 |