Individual Healthcare Provider
Jennier Renee Johnson, PRESIDENT
Provider's NPPES record last updated: October 26, 2011
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1942586532
- Primary Specialty
- Assisted Living Facility
- Practice Location
- Brookston, Minnesota
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 9:12 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Assisted Living Facility
Nursing & Custodial Care Facilities
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.
Taxonomy code 310400000X Custodial Care Facility
Nursing & Custodial Care Facilities
A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.
Taxonomy code 311Z00000XCustodial Care Facility
Adult Care Home
Nursing & Custodial Care Facilities
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.
Taxonomy code 311ZA0620X
Provider-Reported License Information
- Assisted Living Facility (Minnesota)
- 354457
- Custodial Care Facility (Minnesota)
- FBL-26096-34148
- Custodial Care Facility (Minnesota)
- 354448
Practice Locations
Practice Location
8783 2nd Street South
Brookston, Minnesota 55711-0367
Phone: (218) 453-5062
Record Information
- Enumeration Date
- October 26, 2011
- Provider's NPPES Record Last Updated
- October 26, 2011
- NPISignal NPPES Dataset
- August 2026
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