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General NPI Number Information
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NPI Number | 1619342136
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Entity Type | Organization
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Legal Business Name | VIZION HEALTH OKLAHOMA
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 130 A ST SW
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City | MIAMI
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State | OK
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Zip | 74354-6806
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Country | US
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Telephone | 504-717-8614
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Fax |
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Provider Business Mailing Address
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Address Line | 10935 WINDS CROSSING DR SUITE 700
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City | CHARLOTTE
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State | NC
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Zip | 28273-2402
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Country | US
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Telephone | 704-981-2161
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Fax | 310-451-9092
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Authorized Official
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Title or Position | CEO
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Name | MR. MARK EDWIN SCHNEIDER
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Credential |
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Telephone | 504-717-8614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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