Provider Demographics
NPI:1285444141
Name:JOHNSON, DAMION LEWIS
Entity type:Individual
Prefix:
First Name:DAMION
Middle Name:LEWIS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-1155
Mailing Address - Country:US
Mailing Address - Phone:216-269-7917
Mailing Address - Fax:
Practice Address - Street 1:3660 E 52ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-1155
Practice Address - Country:US
Practice Address - Phone:216-269-7917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide