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JOHNSONVILLE HOME LLC
NPI 1952590168
Custodial Care Facility - Adult Care Home in Kansas City, KS

Active since October 24, 2007
2419 N 22ND ST, KANSAS CITY, KS 66104(913) 371-3995(866) 372-9403 Get Directions Write a Review

NPPES record last updated: October 24, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Custodial Care Facility
  • Adult Care Home

About JOHNSONVILLE HOME LLC

This page provides the complete NPI Profile along with additional information for Johnsonville Home Llc, a provider established in Kansas City, Kansas operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1952590168 assigned on October 2007. The practitioner's primary taxonomy code is 311ZA0620X with license number B105114 (KS). The provider is registered as an organization and their NPI record was last updated 19 years ago. The authorized official of this NPI record is Ms. Tiffany L Johnson (Operator)

NPI
1952590168 Verify this NPI
Provider Name
JOHNSONVILLE HOME LLC
Entity Type
Organization
Location Address
2419 N 22ND ST KANSAS CITY, KS 66104
Location Phone
(913) 371-3995
Location Fax
(866) 372-9403
Mailing Address
2419 N 22ND ST KANSAS CITY, KS 66104
Mailing Phone
(913) 371-3995
Mailing Fax
(866) 372-9403
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-24-2007
Last Update Date
10-24-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
B105114
License State
KS
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. TIFFANY L JOHNSON

Authorized Official Title
OPERATOR
Authorized Official Phone
(913) 371-3995

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Frequently Asked Questions

What is JOHNSONVILLE HOME LLC's NPI number?

The NPI number assigned to this healthcare provider is 1952590168, enumerated as an "organization" on October 24, 2007.

Where is the provider located?

The provider is located at 2419 N 22ND ST KANSAS CITY, KS 66104 and the phone number is (913) 371-3995.

What is the provider's specialty?

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.