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General NPI Number Information
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NPI Number | 1679267942
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Entity Type | Organization
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Legal Business Name | VISION WORLD LLC
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 1550 E UNIVERSITY DR STE P7
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City | MESA
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State | AZ
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Zip | 85203-8161
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Country | US
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Telephone | 602-782-0216
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Fax |
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Provider Business Mailing Address
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Address Line | 22280 S 209TH WAY APT 221
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-4954
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. VALENA JORDAN
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Credential |
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Telephone | 602-782-0216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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