Provider Demographics
NPI:1407493273
Name:JOHNSON'S GENTLE CARE LLC
Entity Type:Organization
Organization Name:JOHNSON'S GENTLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-557-2636
Mailing Address - Street 1:7632 TREY RIATA DR APT 124
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-4825
Mailing Address - Country:US
Mailing Address - Phone:318-557-2636
Mailing Address - Fax:
Practice Address - Street 1:7632 TREY RIATA DR APT 124
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-4825
Practice Address - Country:US
Practice Address - Phone:318-557-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care