Healthcare Provider Details

I. General information

NPI: 1669864724
Provider Name (Legal Business Name): VISIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 02/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E BROADWAY STE 100
EUGENE OR
97401-3175
US

IV. Provider business mailing address

9510 SAINT CLAIR AVE
FAIRVIEW HEIGHTS IL
62208-1639
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-6706
  • Fax: 541-343-3259
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: GARY STRANGE
Title or Position: VICE PRESIDENT
Credential:
Phone: 314-409-5973