Kirby Johnson

NPI #1386036564 in Chicago, Illinois

Provider Information

NPI Number: 1386036564
Entity Type: Organization
Organization Name: Kirby Johnson
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 25, 2015
Last Updated: Feb 25, 2015

Practice Location

Address: 3807 N LEAVITT ST APT 2
City: Chicago
State: Illinois
ZIP Code: 60618-3825
Phone: (309) 360-6268

Authorized Official

Name: KIRBY JOHNSON
Title: BEHAVIOR ANALYST
Phone: (309) 360-6268

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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