MEDICARE: JOHNSON HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	374U00000X	Home Health Aide
3	251G00000X	Community Based Hospice Care Agency
4	253Z00000X	In Home Supportive Care Agency
5	302R00000X	Health Maintenance Organization
6	305R00000X	Preferred Provider Organization
7	305S00000X	Point of Service
8	310400000X	Assisted Living Facility
9	311Z00000X	Custodial Care Facility
10	311ZA0620X	Adult Care Home Facility
11	332U00000X	Home Delivered Meals
12	372500000X	Chore Provider
13	372600000X	Adult Companion
14	376J00000X	Homemaker
15	251E00000X	Home Health Agency

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	081097943	OTHER	TX	DUNS NUMBER

General Provider Information

NPI Number	:	1568963726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	19002 DALLAS PKWY APT 1838
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-3160
Country	:	US
Telephone Number	:	469-886-8309
Fax Number	:

Provider Business Practice Location Address
First Line	:	19002 DALLAS PKWY APT 1838
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-3160
Country	:	US
Telephone Number	:	468-886-8309
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YETTA JOHNSON
Credential	:
Telephone Number	:	469-886-8309

Provider Enumeration Date	:	02/23/2018
Last Update Date	:	08/11/2021

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Directions to “JOHNSON HEALTH SERVICES LLC ” Practice Location

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