Healthcare Provider Details

I. General information

NPI: 1376091249
Provider Name (Legal Business Name): VISION HEALTHCARE SERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 YORK ROAD STE 206
BALTIMORE MD
21212
US

IV. Provider business mailing address

6600 YORK RD STE. 206
BALTIMORE MD
21212-2092
US

V. Phone/Fax

Practice location:
  • Phone: 410-377-0154
  • Fax: 410-377-0130
Mailing address:
  • Phone: 410-377-0154
  • Fax: 410-377-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH-2096
License Number StateMD

VIII. Authorized Official

Name: MR. LAWRENCE UKAEGBU
Title or Position: OWNER
Credential: BBA, LPN
Phone: 443-857-4294