Healthcare Provider Details

I. General information

NPI: 1619822038
Provider Name (Legal Business Name): CHRISTOPHER J JOHNSON N/A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 S LIVERNOIS RD
ROCHESTER HILLS MI
48307-4934
US

IV. Provider business mailing address

3712 S LIVERNOIS RD
ROCHESTER HILLS MI
48307-4934
US

V. Phone/Fax

Practice location:
  • Phone: 248-632-9453
  • Fax:
Mailing address:
  • Phone: 248-632-9453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberJ525115367597
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: