Provider Demographics
NPI:1154495745
Name:CATHY JOHNSON CARING FOR OTHERS IN HOME AGENCY
Entity Type:Organization
Organization Name:CATHY JOHNSON CARING FOR OTHERS IN HOME AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-222-0960
Mailing Address - Street 1:902 LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-9724
Mailing Address - Country:US
Mailing Address - Phone:336-222-0960
Mailing Address - Fax:336-222-0970
Practice Address - Street 1:134 W FRONT ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3783
Practice Address - Country:US
Practice Address - Phone:336-222-0960
Practice Address - Fax:336-222-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3396251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601505Medicaid