Gerald Bruce Johnson Valid NPI

Individual provider · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Wasilla, AK

NPI

1609443217

Type

Individual (Type 1)

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities)

Specialty group

Residential Treatment Facilities

Taxonomy code

320900000X

Sex

Male

Sole proprietor

Yes

Enumerated

2021-06-10

Last updated

2025-10-15