MEDICARE: JOHNSONS CLIENT CARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	11791 AND 11792	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548395098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSONS CLIENT CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	4038 MARION PL
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71109-5012
Country	:	US
Telephone Number	:	318-631-7714
Fax Number	:	318-636-7614

Provider Business Practice Location Address
First Line	:	4038 MARION PL
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71109-5012
Country	:	US
Telephone Number	:	318-631-7714
Fax Number	:	318-636-7614

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. DIRECT OWNER CHIEF EXECUTIVE OFFI DIRECTOR
Credential	:	M
Telephone Number	:	318-631-7714

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	08/22/2020

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