Provider Demographics
NPI:1154495703
Name:JOHNSON & JOHNSON ACTIVITIES, INC.
Entity Type:Organization
Organization Name:JOHNSON & JOHNSON ACTIVITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MED
Authorized Official - Phone:281-831-1867
Mailing Address - Street 1:14730 FONDREN ROAD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:17489
Mailing Address - Country:US
Mailing Address - Phone:713-723-2090
Mailing Address - Fax:713-723-2091
Practice Address - Street 1:14730 FONDREN ROAD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:17489
Practice Address - Country:US
Practice Address - Phone:713-723-2090
Practice Address - Fax:713-723-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116312251C00000X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116312Medicaid