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General NPI Number Information
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NPI Number | 1912145293
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Entity Type | Organization
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Legal Business Name | VISIONS OF NORTH CAROLINA INC
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Dates
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Enumeration Date | 01/26/2009
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Last Update Date | 01/26/2009
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Provider Practice Location Address
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Address Line | 7607A ALCORN RD SAME
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City | GREENSBORO
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State | NC
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Zip | 27409-9781
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Country | US
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Telephone | 336-931-0432
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Fax | 336-370-9009
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Provider Business Mailing Address
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Address Line | 7607A ALCORN RD SAME
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City | GREENSBORO
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State | NC
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Zip | 27409-9781
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Country | US
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Telephone | 336-931-0432
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Fax | 336-370-9009
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DR. HERBERT LEE MOZELL
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Credential | ED.D
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Telephone | 336-931-0432
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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 | NC
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