Healthcare Provider Details

I. General information

NPI: 1952095978
Provider Name (Legal Business Name): ENVISION HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 FRANKLIN ST
ROCKY MOUNT VA
24151-6388
US

IV. Provider business mailing address

5825 FIGSBORO RD
MARTINSVILLE VA
24112-7937
US

V. Phone/Fax

Practice location:
  • Phone: 540-238-2113
  • Fax:
Mailing address:
  • Phone: 127-679-0464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHANNON WALKER HUFFMAN
Title or Position: CEO
Credential:
Phone: 540-238-2113