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General NPI Number Information
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NPI Number | 1013269281
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Entity Type | Organization
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Legal Business Name | ENVISION AMERICA INC
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 2304 N CONGRESS AVE
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-1910
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Country | US
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Telephone | 561-249-0902
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Fax | 561-623-7027
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Provider Business Mailing Address
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Address Line | PO BOX 3143
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City | WEST PALM BEACH
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State | FL
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Zip | 33402-3143
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Country | US
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Telephone | 561-249-0902
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Fax | 561-623-7027
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ADRIANE MARCELLE
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Credential |
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Telephone | 561-249-0902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 50-51-1392887
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License Number State | FL
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