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General NPI Number Information
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NPI Number | 1073984316
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Entity Type | Organization
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Legal Business Name | A VALLEY OF VISIONS, LLC
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 307 MAIN ST E
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City | AHOSKIE
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State | NC
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Zip | 27910-3419
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Country | US
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Telephone | 252-642-5345
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 134
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City | COLERAIN
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State | NC
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Zip | 27924-0134
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Country | US
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Telephone | 252-642-5345
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | VICKIE PERSAUD
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Credential | MS
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Telephone | 252-642-5345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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