Healthcare Provider Details

I. General information

NPI: 1477235844
Provider Name (Legal Business Name): NEW VISIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 ELM ST
BASTROP LA
71220-5168
US

IV. Provider business mailing address

713 ELM ST
BASTROP LA
71220-5168
US

V. Phone/Fax

Practice location:
  • Phone: 318-669-9383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALANDRIUS SMITH
Title or Position: CEO
Credential:
Phone: 318-669-9383