JOHNSON CUSTODIAL HOME, INC. (NPI# 1407853823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407853823 |
| Entity Type | Organization |
| Organization Name | JOHNSON CUSTODIAL HOME, INC. |
| Other Organization Name | MAGGIE JOHNSON NURSING CENTER |
| Practice Address |
3406 E 17th St Austin TX 78721-1106 |
| Mailing Address |
3801 Woodside Dr Arlington TX 76016-3030 |
| Practice Telephone | 5129264760 |
| Practice Fax Number | 5129289565 |
| Mailing Telephone | 8176543042 |
| Mailing Fax Number | 8174463666 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHERYL L KILLIAN (PRESIDENT) |
| Authorized Official Telephone | 8176543042 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 111923 | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 4694 | 05 |
| Other Name | Type Code |
|---|---|
| Maggie Johnson Nursing Center | Doing Business As Name - Organization |
| Street Address |
3406 E 17TH ST |
| City | AUSTIN |
| State | TX |
| Zip Code | 78721-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023119716 | Jeffree Augusta James | Internal Medicine | 3232 East Martin Luther King Jr. Blvd, Austin, TX 78721-1043 | 2006-09-26 |
| 1518208511 | Hughes Horner Care LLC | In Home Supportive Care | 3406 E Mlk Jr Blvd, Austin, TX 78721-1047 | 2013-03-15 |
| 1275714750 | Henry Chukwudi Ebem | Physical Therapist | 3218 E Martin Luther King Jr Blvd Ste 102, Austin, TX 78721-1054 | 2007-11-26 |
| 1669089504 | Tess Lenae Taylor | Counselor | 1205 Luna St, Austin, TX 78721-1229 | 2020-09-24 |
| 1184900714 | Steven Allen Blaisdell | Counselor | 1212 Luna St, Austin, TX 78721-1230 | 2011-10-27 |
| 1831598275 | Ryan Authier | Counselor | 1801 Elmira Rd, Austin, TX 78721-1314 | 2014-08-21 |
| 1346646296 | Lacresa Mckinney | Custodial Care Facility | 1807 Springdale Rd, Austin, TX 78721-1348 | 2014-11-05 |
| 1669620357 | Loving Care Homes Ministries- Webberville House | Assisted Living Facility | 1808 Webberville Rd, Austin, TX 78721-1506 | 2008-09-05 |
| 1639240799 | Deborah Ann Taylor | Specialist | 4802 Heflin Ln, Austin, TX 78721-1524 | 2006-11-12 |
| 1184135741 | Leeann Raye Terwilliger | Social Worker | 5105 Stone Gate Dr, Austin, TX 78721-1611 | 2017-10-22 |
| Find all providers in zip 78721 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841598489 | Smithville Hospital Authority | Nursing Facility/Intermediate Care Facility | 9801 S 1st St, Austin, TX 78748-6760 | 2011-03-07 |
| 1184709602 | Oakcrest Manor Nursing Home LLC | Nursing Facility/Intermediate Care Facility | 9808 Crofford Ln, Austin, TX 78724-1004 | 2006-10-25 |
| 1457316176 | Oakbend Medical Center | Nursing Facility/Intermediate Care Facility | 2806 Real St, Austin, TX 78722-1715 | 2006-04-18 |
| 1720062441 | Regency Village Care Center, Ltd | Nursing Facility/Intermediate Care Facility | 6500 Brush Country Rd, Austin, TX 78749-1403 | 2005-12-06 |
| 1487641296 | Polk Nursing Home Limited Partnership | Nursing Facility/Intermediate Care Facility | 6633 E Highway 290, Suite # 202, Austin, TX 78723-1172 | 2005-10-06 |
| 1407349699 | Regency Ihs of Heritage Park LLC | Nursing Facility/Intermediate Care Facility | 2806 Real St, Austin, TX 78722-1715 | 2018-06-12 |
| 1619460896 | Regency Ihs of Windsor Duval LLC | Nursing Facility/Intermediate Care Facility | 5301 W Duval Rd, Austin, TX 78727-6618 | 2018-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922660471 | Castro County Hospital District | Nursing Facility/Intermediate Care Facility | 701 Butler Blvd, Dimmitt, TX 79027-2720 | 2019-07-05 |
| 1023674520 | Eunice Nadine Hall | Nursing Facility/Intermediate Care Facility | 110 W. Troupe St, Mabank, TX 75147-8651 | 2019-05-10 |
| 1467945626 | Regency Ihs of Windsor Mission Oaks LLC | Nursing Facility/Intermediate Care Facility | 3030 S Roosevelt Ave, San Antonio, TX 78214-2337 | 2018-06-12 |
| 1508363086 | Solomon Ishaq | Nursing Facility/Intermediate Care Facility | 1818 Arundel Dr, Carrollton, TX 75007-3012 | 2018-04-10 |
| 1740798651 | Mission Valley Nursing and Transitional Care LLC | Nursing Facility/Intermediate Care Facility | 1200 S Bryan Rd, Mission, TX 78572-6840 | 2018-01-12 |
| 1841738580 | Su Casa Adult Foster Home | Nursing Facility/Intermediate Care Facility | 12462 Paseo De Arco Ct, El Paso, TX 79928-5669 | 2017-02-02 |
| 1225402753 | West Wharton County Hospital District | Nursing Facility/Intermediate Care Facility | 248 Wisteria Ln, El Campo, TX 77437-2545 | 2015-11-20 |
| 1447635040 | Sarah Padlan I | Nursing Facility/Intermediate Care Facility | 3808 Veterans Blvd, Studio 6, Del Rio, TX 78840-2859 | 2015-07-23 |
| 1902289358 | Fnu Anushree | Nursing Facility/Intermediate Care Facility | 328 Bedford Rd Apt 247, Bedford, TX 76022-8032 | 2015-07-02 |
| 1699154278 | Royal Manor Care Center, Inc. | Nursing Facility/Intermediate Care Facility | 4545 S Buckner Blvd, Dallas, TX 75227-4207 | 2015-05-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JOHNSON CUSTODIAL HOME, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.