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General NPI Number Information
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NPI Number | 1619212313
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Entity Type | Organization
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Legal Business Name | NEW VISION SERVICES INC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 2253 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10035-2206
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Country | US
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Telephone | 917-405-9363
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Fax | 877-453-3687
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Provider Business Mailing Address
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Address Line | PO BOX 358
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City | REEDERS
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State | PA
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Zip | 18352-0358
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Country | US
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Telephone | 917-405-9363
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Fax | 877-453-3687
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Authorized Official
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Title or Position | CEO
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Name | MS. WANDA FORDEN
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Credential |
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Telephone | 917-405-9363
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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 |
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License Number State |
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