NPI 1942893250

Johnson Estate LLC

Organisation Assisted Living Facility (Mental Illness) Pontiac, MI

Practice location

Address: 116 N Johnson St, Pontiac, MI 48341-1330
Phone: (248) 481-7120
Fax: (248) 481-8786

Authorised official

Name: Ms.Kim K Young
Title: Program Coordinator
Phone: (248) 481-7120

Registered specialties

Assisted Living Facility (Mental Illness) Primary

Nursing & Custodial Care Facilities Taxonomy 3104A0625X

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Registry record

NPI: 1942893250
Entity type: Organization
NPI issued: 17 Feb 2021
Record last updated: 17 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.