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Mr. Johnnie Legrant Lee
Adult Care Home Facility in Minneapolis, Minnesota
NPI 1104174085

Johnnie Legrant Lee is an Adult Care Home Facility based in Minneapolis, MN and is specialized in Adult Care Home. Johnnie Legrant Lee practices in Minneapolis, MN. The NPI Number for Johnnie Legrant Lee is 1104174085 and holds a License No. 270227392 (Minnesota).

The current practice location address for Johnnie Legrant Lee is 4347 4Th Ave S, Minneapolis, MN and can be reached out via phone at 612-823-3880.

Location: 4347 4Th Ave S, Minneapolis, MN, 55409-2115
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104174085
Provider Name
Johnnie Legrant Lee
Credential
Provider Entity Type
Individual
Gender
Male
Address
4347 4Th Ave S, Minneapolis, MN, 55409-2115
Phone Number
612-823-3880
Fax Number
Provider Enumeration Date
08/26/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4347 4Th Ave S
City
Minneapolis
State
Minnesota
Zip
55409-2115
Phone Number
612-823-3880
Fax Number
person
Provider Business Mailing Address Details
Address
4347 4Th Ave S
City
Minneapolis
State
Minnesota
Zip
55409-2115
Phone Number
612-823-3880
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
311ZA0620X
License No.
270227392 (Minnesota)
Definition
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.
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