RONALD R. JOHNSON NPI 1013125467

NPI Information

NPI: 1013125467
Provider Name: RONALD R. JOHNSON

Doing Business As: UNDERWOOD MANOR LLHCSA

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
4460 UNION HILL RD
HINSDALE, NY
ZIP 14743
Phone: (716) 557-2322
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RONALD R. JOHNSON is an adult care home custodial care facility in Hinsdale, NY. 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. RONALD R. JOHNSON NPI is 1013125467. The provider is registered as an organization entity type.
The provider Is Doing Business As Underwood Manor Llhcsa.

The provider's business location address is:

4460 UNION HILL RD
HINSDALE, NY
ZIP 14743-715
Phone: (716) 557-2322

The provider's authorized official is Ronald Ray Johnson .
The authorized official title is Owner and has the following contact phone number (716) 595-8784.

The enumeration date for this NPI number is 5/18/2007 and was last updated on 8/22/2020.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	311ZA0620X	Custodial Care Facility	Adult Care Home	0671A003	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02731313	MEDICAID	NEW YORK
2	0671A003	OTHER	NEW YORK	DOH LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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