MR. JOHNNIE LEGRANT LEE NPI 1104174085

NPI Information

MR. Johnnie Legrant Lee is an adult care home custodial care facility in Minneapolis, MN. The provider is 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. MR. Johnnie Legrant Lee NPI is 1104174085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4347 4TH AVE S
MINNEAPOLIS, MN
ZIP 55409-115
Phone: (612) 823-3880

The enumeration date for this NPI number is 8/26/2012 and was last updated on 8/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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