MEDICARE: JOHNSON'S GENTLE CARE HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	261QR0800X	Recovery Care Clinic/Center
3	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1548894959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON'S GENTLE CARE HOMES LLC

Provider Business Mailing Address
First Line	:	201 ARMSTRONG DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-2348
Country	:	US
Telephone Number	:	817-404-7004
Fax Number	:

Provider Business Practice Location Address
First Line	:	7632 TREY RIATA DR APT 124
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-4825
Country	:	US
Telephone Number	:	318-557-2636
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRISHANNA T HARGROVE
Credential	:
Telephone Number	:	817-404-7004

Provider Enumeration Date	:	02/24/2020
Last Update Date	:	01/13/2026

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