Travis Johnson
Respite Care in Mentor, OH. Individual provider (NPI-1).
NPI number1891516431
StatusActive
Last updated in NPPESNov 25, 2024
Details
- NPI
- 1891516431
- Entity type
- Individual (NPI-1)
- Name
- Travis Johnson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 17, 2024
- Certification date
- Nov 25, 2024
- Last updated
- Nov 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 385H00000X | Respite Care | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 374U00000X | Home Health Aide | – | – |
Practice location
8500 Station StMentor, OH 44060-4943
Phone 216-857-8527
Mailing address
8500 Station StMentor, OH 44060-4943
Phone 216-857-8527
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