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General NPI Number Information
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NPI Number | 1609917806
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Entity Type | Organization
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Legal Business Name | VISIONS II
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 611 W HARRISON ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-4621
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Country | US
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Telephone | 336-348-6939
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W HARRISON ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-4621
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Country | US
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Telephone | 336-348-6939
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Fax |
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Authorized Official
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Title or Position | QUALIFIED PROFESSIONAL OWNER
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Name | MR. GREGORY LAMONT HOPKINS
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Credential | B.S.,Q.P.
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Telephone | 336-348-6939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MHL-079-085
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License Number State | NC
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