Provider Demographics
NPI:1144881590
Name:M. JOHNSON AND ASSOCIATES LLC
Entity type:Organization
Organization Name:M. JOHNSON AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN CCM
Authorized Official - Phone:810-895-5091
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-5258
Mailing Address - Country:US
Mailing Address - Phone:810-895-5091
Mailing Address - Fax:810-895-5014
Practice Address - Street 1:3592 GENESEE RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2914
Practice Address - Country:US
Practice Address - Phone:810-895-5091
Practice Address - Fax:810-895-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management