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General NPI Number Information
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NPI Number | 1528658671
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Entity Type | Organization
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Legal Business Name | JOHNSON COMFORT HOMES, LLC
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 1707 US HIGHWAY 72 W
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City | ATHENS
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State | AL
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Zip | 35611-2948
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Country | US
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Telephone | 256-466-2131
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Fax |
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Provider Business Mailing Address
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Address Line | 2024 BRAYDEN DR SW
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City | DECATUR
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State | AL
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Zip | 35603-2476
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Country | US
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Telephone | 256-654-4820
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACIA JOHNSON
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Credential |
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Telephone | 256-654-4820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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