MEDICARE: JOHNHENRY 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1740130830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNHENRY CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1321 VILLA PALOMA BLVD
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-4923
Country	:	US
Telephone Number	:	573-529-7026
Fax Number	:

Provider Business Practice Location Address
First Line	:	1321 VILLA PALOMA BLVD
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-4923
Country	:	US
Telephone Number	:	573-529-7026
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	LESLIE ANN LOGAN
Credential	:
Telephone Number	:	573-529-7026

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	03/18/2026

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Directions to “JOHNHENRY CARE SERVICES LLC ” Practice Location

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