Provider Demographics
NPI:1548894959
Name:JOHNSON'S GENTLE CARE HOMES LLC
Entity type:Organization
Organization Name:JOHNSON'S GENTLE CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHANNA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HARGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-404-7004
Mailing Address - Street 1:201 ARMSTRONG DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2348
Mailing Address - Country:US
Mailing Address - Phone:817-404-7004
Mailing Address - Fax:
Practice Address - Street 1:7632 TREY RIATA DR APT 124
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-4825
Practice Address - Country:US
Practice Address - Phone:318-557-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care