MR. JOHNNIE LEGRANT LEE
NPI 1104174085
Custodial Care Facility - Adult Care Home in Minneapolis, MN

Q: What is Johnnie Lee's NPI number?

The NPI number for Johnnie Lee is 1104174085. It was assigned to this individual provider in the NPPES registry on August 26, 2012.

Q: What is Johnnie Lee's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Q: When was this NPI record last updated?

The NPPES record for Johnnie Lee was last updated on August 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 26, 2012

4347 4TH AVE S, MINNEAPOLIS, MN 55409(612) 823-3880 Get Directions Write a Review

NPPES record last updated: August 26, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mr. Johnnie Legrant Lee NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JOHNNIE LEGRANT LEE (NPI 1104174085) is an individual adult care home provider in Minneapolis, Minnesota, licensed in Minnesota (270227392) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1104174085

Entity TypeIndividualMale

Primary Taxonomy311ZA0620X

Provider Legal NameMR. JOHNNIE LEGRANT LEE

Location Address4347 4TH AVE SMinneapolis, MN 55409-2115

Mailing Address4347 4th Ave SMinneapolis, MN 55409-2115 · (612) 823-3880

Phone(612) 823-3880

Sole ProprietorYes

Enumeration DateAugust 26, 2012

✔ NPI 1104174085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities

Taxonomy Code311ZA0620X

License✔ Licensed in MN · 270227392

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

4347 4TH AVE S, Minneapolis, MN 55409

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnnie Lee's NPI number?

The NPI number for Johnnie Lee is 1104174085. It was assigned to this individual provider in the NPPES registry on August 26, 2012.

Where is Johnnie Lee located?

Johnnie Lee practices at 4347 4th Ave S, Minneapolis, MN 55409. The listed phone number is (612) 823-3880.

What is Johnnie Lee's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Johnnie Lee was last updated on August 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.