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General NPI Number Information
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NPI Number | 1245422187
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Entity Type | Organization
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Legal Business Name | RIDGILL JOHNSON PROPERTIES, INC
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 3557 ATLANTIC AVENUE SUITE 188
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City | LONG BEACH
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State | CA
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Zip | 90807
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Country | US
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Telephone | 310-248-8405
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Fax | 877-750-3008
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Provider Business Mailing Address
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Address Line | 3557 ATLANTIC AVENUE SUITE 188
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City | LONG BEACH
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State | CA
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Zip | 90807
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Country | US
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Telephone | 310-248-8405
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Fax | 877-750-3008
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Authorized Official
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Title or Position | PRESIDENT
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Name | BYRON JOHNSON
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Credential |
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Telephone | 310-242-8405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 940000075
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License Number State | CA
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