Individual provider · Type 1 NPI

Jeffery Johnson

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Tampa, FL

NPI number 1700725736 Active

Practice location

10905 N 14th St
Tampa, FL 33612-5921

Call (813) 404-3044 Map

Fax (813) 754-1659

Mailing address

1225 Alpine Lake Dr
Brandon, FL 33511-1898

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000X6200-SC (FL)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1700725736

Jeffery Johnson's National Provider Identifier is 1700725736, issued on Mar 26, 2026. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Tampa, FL. The record was last updated on Mar 26, 2026.