MEDICARE: VISION BEHAVIORAL HEALTH 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	251S00000X	Community/Behavioral Health Agency

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	:	1255501649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION BEHAVIORAL HEALTH SERVICES,LLC

Provider Business Mailing Address
First Line	:	495 ARBOR HILL RD
Second Line	:	SUITE E
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-3374
Country	:	US
Telephone Number	:	336-992-0429
Fax Number	:	336-993-3709

Provider Business Practice Location Address
First Line	:	495 ARBOR HILL RD
Second Line	:	SUITE E
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-3374
Country	:	US
Telephone Number	:	336-992-0429
Fax Number	:	336-993-3709

Authorized Official
Title or Position	:	CEO
Name	:	MORRIS GARRETT
Credential	:
Telephone Number	:	336-992-0429

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	03/03/2008

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