Provider Demographics
NPI:1407428576
Name:JOHNSON VOCATIONAL SERVICES LLC
Entity Type:Organization
Organization Name:JOHNSON VOCATIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, JOB COACH, ETC.
Authorized Official - Prefix:
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-602-9180
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-0652
Mailing Address - Country:US
Mailing Address - Phone:337-602-9180
Mailing Address - Fax:
Practice Address - Street 1:801 KING ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-5109
Practice Address - Country:US
Practice Address - Phone:373-602-9180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty