Healthcare Provider Details

I. General information

NPI: 1356377014
Provider Name (Legal Business Name): ANDREWS AND JOHNSON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7404 N. BRAY ROAD
MT. MORRIS MI
48458
US

IV. Provider business mailing address

P.O. BOX 457
GENESEE MI
48437
US

V. Phone/Fax

Practice location:
  • Phone: 810-686-2198
  • Fax: 810-686-0915
Mailing address:
  • Phone: 810-785-0344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DEELLA JEAN JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 810-785-0344