Healthcare Provider Details

I. General information

NPI: 1194190892
Provider Name (Legal Business Name): A JOINT VISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 HIRE CIR
OCOEE FL
34761-3166
US

IV. Provider business mailing address

911 HIRE CIR
OCOEE FL
34761-3166
US

V. Phone/Fax

Practice location:
  • Phone: 407-431-8831
  • Fax:
Mailing address:
  • Phone: 407-431-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VICKIE MARIE FERGUSON
Title or Position: CEO
Credential: B.S.
Phone: 407-431-8831