=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376745232
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW VISION HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2007
-----------------------------------------------------
Last Update Date | 10/23/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 58725 BELLEVIEW DR SUITE A2
-----------------------------------------------------
City | PLAQUEMINE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70764-3948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-687-3330
-----------------------------------------------------
Fax | 225-687-3302
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 58725 BELLEVIEW DR SUITE A2
-----------------------------------------------------
City | PLAQUEMINE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70764-3948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 225-687-3302
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROGRAM DIRECTOR
-----------------------------------------------------
Name | DIONNE HARVEY
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 225-687-3330
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------