Individual provider · Type 1 NPI

Nedra Johnson

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Dallas, TX

NPI number 1265941512 Active

Practice location

5409 N Jim Miller Rd Ste 211
Dallas, TX 75227-1523

Call (214) 280-0379 Map

Fax (214) 817-2571

Mailing address

PO Box 270376
Dallas, TX 75227-0376

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Driver 172A00000XNone listed
Renal Dialysis Technician 2472R0900XNone listed
Developmentally Disabled Services Day Training Agency 251C00000XNone listed
Home Health Agency 251E00000XNone listed
PACE Provider Organization 251T00000XNone listed
Voluntary or Charitable Agency 251V00000XNone listed
Foster Care Agency 253J00000XNone listed
Adult Day Care Clinic/Center 261QA0600XNone listed
Home Delivered Meals 332U00000XNone listed
Transportation Network Company 342000000XNone listed
Private Vehicle 347C00000XNone listed
Adult Companion 372600000XNone listed
Home Health Aide 374U00000XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1265941512

Nedra Johnson's National Provider Identifier is 1265941512, issued on Sep 28, 2017. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Dallas, TX. The record was last updated on Jan 13, 2023.