Provider Demographics
NPI:1467876219
Name:LISA JOHNS LLC
Entity Type:Organization
Organization Name:LISA JOHNS LLC
Other - Org Name:GUARDIAN HOSPICE OF OKLAHOMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-815-5112
Mailing Address - Street 1:614 N TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-4949
Mailing Address - Country:US
Mailing Address - Phone:903-868-0267
Mailing Address - Fax:903-868-0297
Practice Address - Street 1:1055 N SERVICE RD
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:OK
Practice Address - Zip Code:74730-1806
Practice Address - Country:US
Practice Address - Phone:580-434-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based