Individual provider · Type 1 NPI
Johnnie Legrant Lee
Adult Care Home Facility · Minneapolis, MN
NPI number
1104174085
Active
Practice location
4347 4th Ave S
Minneapolis, MN 55409-2115
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | 270227392 (MN) |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1104174085
Johnnie Legrant Lee's National Provider Identifier is 1104174085, issued on Aug 26, 2012. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Minneapolis, MN. The record was last updated on Aug 26, 2012.