MEDICARE: ENVISIONED BEHAVIORAL HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1306639323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENVISIONED BEHAVIORAL HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	661 ARNETT BLVD # 110
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-2506
Country	:	US
Telephone Number	:	434-489-0004
Fax Number	:

Provider Business Practice Location Address
First Line	:	661 ARNETT BLVD # 110
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-2506
Country	:	US
Telephone Number	:	434-489-0004
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANITRIA HENDERSON
Credential	:
Telephone Number	:	434-489-0004

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	05/22/2025

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Directions to “ENVISIONED BEHAVIORAL HEALTH SERVICES, LLC ” Practice Location

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