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General NPI Number Information
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NPI Number | 1417121229
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Entity Type | Organization
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Legal Business Name | OMNI VISIONS, INC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 231 E ARCH ST
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City | MADISONVILLE
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State | KY
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Zip | 42431-2003
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Country | US
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Telephone | 270-825-1698
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Fax | 270-825-8050
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Provider Business Mailing Address
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Address Line | 301 S PERIMETER PARK DR SUITE 210
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City | NASHVILLE
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State | TN
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Zip | 37211-4143
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Country | US
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Telephone | 615-726-3603
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Fax | 615-726-3632
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES M HENRY
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Credential |
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Telephone | 615-726-3603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | SO 09985A
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 500533
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License Number State | KY
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