Individual provider · Type 1 NPI
Gerald Bruce Johnson
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Wasilla, AK
Practice location
4092 W Marble Way
Wasilla, AK 99654-8752
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None 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.
2 other providers at this address
Other intellectual and/or developmental disabilities community based residential treatment facility providers in Wasilla
About NPI 1609443217
Gerald Bruce Johnson's National Provider Identifier is 1609443217, issued on Jun 10, 2021. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Wasilla, AK. The record was last updated on Oct 15, 2025.