IndividualActive
Johnnie Lee
NPI 1104174085 · Adult Care Home Facility · Minneapolis, MN
Provider details
- NPI number
- 1104174085
- Entity type
- Individual
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- 270227392 (MN)
Mailing address
4347 4th Ave S
Minneapolis, MN 55409-2115
Registry dates
- Enumerated
- 2012-08-26
- Last updated
- 2012-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.