Johnson Estate LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

JOHNSON ESTATE LLC

Doing business as

Jet LLC

Practice address

116 N Johnson St
Pontiac, MI 48341-1330

Phone

(248) 481-7120

Fax

(248) 481-8786

NPI assigned

Feb 17, 2021

Last updated

Feb 17, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ms.Kim K Young, LLMSW

Title

Program Coordinator

Phone

(248) 481-7120

Specialties & licenses 1

Addresses

Other names 1

• Jet LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kim Kory Young, M.HTECHICIAN/L.L.MSW

  • Other Technician
  • Pontiac, MI
  • NPI 1083160790
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1942893250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N JOHNSON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411330",
            "telephone_number": "248-481-7120",
            "fax_number": "248-481-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N JOHNSON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411330",
            "telephone_number": "248-481-7120",
            "fax_number": "248-481-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON ESTATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MS.KIM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "248-481-7120",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jet LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Ann Jennings, RN
• Suzanne M. Jermstad, NP
• Myeya Jernagin
• Fadi Nader Jirjees, MD
• David Johns
• Antania Johnson, BSW
• Bridget Lynn Johnson
• Cateeva M Johnson
• Erik Johnson, DO
• Erinn Martine Johnson, LMSW

• Assisted Living Facility (Mental Illness) in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Assisted Living Facility (Mental Illness) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.