MEDICARE: VISIONS COMMUNITY SERVICES,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	60802006	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144686965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONS COMMUNITY SERVICES,LLC

Provider Business Mailing Address
First Line	:	370 CLEVELAND PL
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6529
Country	:	US
Telephone Number	:	757-965-3200
Fax Number	:	757-965-3201

Provider Business Practice Location Address
First Line	:	370 CLEVELAND PL
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6529
Country	:	US
Telephone Number	:	757-965-3200
Fax Number	:	757-965-3201

Authorized Official
Title or Position	:	PRESIDENT / C.E.O.
Name	:	MRS. EULAMAE RUTLEDGE MYERS
Credential	:
Telephone Number	:	757-965-3200

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	01/08/2016

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