=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518886423
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OPPORTUNITY FOR HOUSING HEALTHCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2026
-----------------------------------------------------
Last Update Date | 07/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2938 JUSTINA RD
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32277-3479
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-432-3333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6181 SANDLER CHASE TRL
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32222-1491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-432-3333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SHUANTELL GRAHAM JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 850-432-3333
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------