Provider Demographics
NPI:1144553447
Name:JOHNSON ALLIED SUPPORT SERVICES, INC
Entity type:Organization
Organization Name:JOHNSON ALLIED SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNDON
Authorized Official - Middle Name:BYRON
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-539-3990
Mailing Address - Street 1:3215 GUESS RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2665
Mailing Address - Country:US
Mailing Address - Phone:919-471-9860
Mailing Address - Fax:919-261-6493
Practice Address - Street 1:3215 GUESS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2665
Practice Address - Country:US
Practice Address - Phone:919-471-9860
Practice Address - Fax:919-261-6493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health