NPI 1023608049

Shellise Johnson

Practitioner Assisted Living Facility Baltimore, MD

Practice location

Address: 1703 E 29th St, Baltimore, MD 21218-3745
Phone: (443) 869-6882
Mailing address: 703 Macdill Rd, Middle River, MD 21220-3794

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 30AL3875 (MD)

Other Assisted Living Facility providers in Maryland →

Registry record

NPI: 1023608049
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jan 2021
Record last updated: 23 Jan 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.