Healthcare Provider Details

I. General information

NPI: 1912718115
Provider Name (Legal Business Name): VISION27 INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3806 WALTON DR
LANSING MI
48910-4365
US

IV. Provider business mailing address

3806 WALTON DR
LANSING MI
48910-4365
US

V. Phone/Fax

Practice location:
  • Phone: 313-753-2038
  • Fax:
Mailing address:
  • Phone: 313-753-2038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SHADRACK AMRI JUMBE
Title or Position: PRESIDENT
Credential:
Phone: 313-753-2038