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General NPI Number Information
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NPI Number | 1184089757
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Entity Type | Organization
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Legal Business Name | PEOPLE WITH VISIONS GOING PLACES
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | 1607 CRAWFORD RD
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City | CLEVELAND
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State | OH
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Zip | 44106-1511
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Country | US
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Telephone | 614-843-5015
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Fax | 216-860-4502
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Provider Business Mailing Address
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Address Line | 1607 CRAWFORD RD
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City | CLEVELAND
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State | OH
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Zip | 44106-1511
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Country | US
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Telephone | 614-843-5015
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Fax | 216-860-4502
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Authorized Official
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Title or Position | CEO
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Name | MS. ALECEANDRIA DENISE WILLIAMSON
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Credential | CDCA, BA,MA,QMHS,
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Telephone | 614-843-5015
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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 | 050155
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 050155
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 050155
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 050155
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License Number State | OH
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