Provider Demographics
NPI:1619920774
Name:LISA JOHNSON
Entity Type:Organization
Organization Name:LISA JOHNSON
Other - Org Name:NEW CARE ADULT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-750-0916
Mailing Address - Street 1:1711 LAKE CHARLOTTE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-8096
Mailing Address - Country:US
Mailing Address - Phone:281-750-0916
Mailing Address - Fax:281-750-0917
Practice Address - Street 1:1711 LAKE CHARLOTTE LN
Practice Address - Street 2:SUITE B
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-8096
Practice Address - Country:US
Practice Address - Phone:281-750-0916
Practice Address - Fax:281-750-0917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0008743251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679495Medicare ID - Type UnspecifiedHOME HEALTH AGENCY