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Tara Demetria Johnson
Assisted Living Facility in Palm Bay, Florida
NPI 1851883706

Tara Demetria Johnson is an Assisted Living Facility based in Palm Bay, FL. Tara Demetria Johnson practices in Palm Bay, FL. The NPI Number for Tara Demetria Johnson is 1851883706 and holds a License No. ALF13181 (Florida).

The current practice location address for Tara Demetria Johnson is 226 Abalone Rd Nw, Palm Bay, FL and can be reached out via phone at 321-480-4052.

Location: 226 Abalone Rd Nw, Palm Bay, FL, 32908-1200
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851883706
Provider Name
Tara Demetria Johnson
Credential
Provider Entity Type
Individual
Gender
Female
Address
226 Abalone Rd Nw, Palm Bay, FL, 32908-1200
Phone Number
321-480-4052
Fax Number
Provider Enumeration Date
06/05/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
FL 05 FL
institution
Provider Business Practice Location Address Details
Address
226 Abalone Rd Nw
City
Palm Bay
State
Florida
Zip
32907-2964
Phone Number
321-480-4052
Fax Number
person
Provider Business Mailing Address Details
Address
226 Abalone Rd Nw
City
Palm Bay
State
Florida
Zip
32907-2964
Phone Number
321-480-4052
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
ALF13181 (Florida)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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