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General NPI Number Information
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NPI Number | 1528545340
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Entity Type | Organization
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Legal Business Name | ANOTHER VISION INC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 8021 BELLA VISTA CT
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City | CHARLOTTE
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State | NC
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Zip | 28216
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Country | US
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Telephone | 980-258-9315
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Fax |
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Provider Business Mailing Address
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Address Line | 8021 BELLA VISTA CT
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City | CHARLOTTE
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State | NC
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Zip | 28216-2043
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Country | US
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Telephone | 980-258-9315
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | MS. MARQUITA RUSSELL
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Credential |
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Telephone | 980-258-9315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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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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