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General NPI Number Information
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NPI Number | 1285100024
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Entity Type | Organization
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Legal Business Name | JUDITH JOHNSON
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 2828 FOREST LN STE 1102
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City | DALLAS
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State | TX
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Zip | 75234-7500
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Country | US
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Telephone | 469-522-7802
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Fax |
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Provider Business Mailing Address
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Address Line | 2828 FOREST LN STE 1102
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City | DALLAS
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State | TX
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Zip | 75234-7500
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Country | US
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Telephone | 214-629-2815
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Fax | 888-205-0443
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JUDITH JOHNSON
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Credential |
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Telephone | 214-629-2815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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