Johnson Home Assisted Living, Inc.

NPI #1447615968 in Pueblo, Colorado

Provider Information

NPI Number: 1447615968
Entity Type: Organization
Organization Name: Johnson Home Assisted Living, Inc.
Primary Specialty: Assisted Living Facility - Assisted Living, Mental Illness
Enumeration Date: Dec 28, 2015
Last Updated: Dec 29, 2015

Practice Location

Address: 403 W 13TH ST
City: Pueblo
State: Colorado
ZIP Code: 81003-2748
Phone: (719) 543-0306

Authorized Official

Name: MR. PAUL SPICOLA
Title: VICE-PRESIDENT
Phone: (719) 369-4567

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X	Primary

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