Provider Demographics
NPI:1548395098
Name:JOHNSONS CLIENT CARE SERVICES, LLC
Entity Type:Organization
Organization Name:JOHNSONS CLIENT CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIRECT OWNER
Authorized Official - Middle Name:CHIEF EXECUTIVE OFFI
Authorized Official - Last Name:DIRECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:M
Authorized Official - Phone:318-631-7714
Mailing Address - Street 1:4038 MARION PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71109-5012
Mailing Address - Country:US
Mailing Address - Phone:318-631-7714
Mailing Address - Fax:318-636-7614
Practice Address - Street 1:4038 MARION PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71109-5012
Practice Address - Country:US
Practice Address - Phone:318-631-7714
Practice Address - Fax:318-636-7614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11791 AND 11792251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1624756Medicaid
LA1624519Medicaid
LA1624551Medicaid