Healthcare Provider Details

I. General information

NPI: 1699698076
Provider Name (Legal Business Name): BIG VISION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 W GARRISON AVE
BALTIMORE MD
21215-5714
US

IV. Provider business mailing address

52 CARDINAL CT
ESSEX MD
21221-5870
US

V. Phone/Fax

Practice location:
  • Phone: 410-205-3120
  • Fax:
Mailing address:
  • Phone: 410-205-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. JUOCHI IWEALA
Title or Position: CEO/ADMINISTRATOR
Credential: CAC-AD
Phone: 410-205-3120