Individual provider · Type 1 NPI
Jennier Renee Johnson, PRESIDENT
Assisted Living Facility · Brookston, MN
NPI number
1942586532
Active
Practice location
8783 2nd Street South
Brookston, MN 55711-0367
Fax (218) 453-5064
Mailing address
Box 367, 8783 2nd Street S
Brookston, MN 55711-0367
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility Primary | 310400000X | 354457 (MN) |
| Custodial Care Facility | 311Z00000X | FBL-26096-34148 (MN) |
| Adult Care Home Facility | 311ZA0620X | 354448 (MN) |
Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Another provider at this address
About NPI 1942586532
Jennier Renee Johnson, PRESIDENT's National Provider Identifier is 1942586532, issued on Oct 26, 2011. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Brookston, MN. The record was last updated on Oct 26, 2011.