MEDICARE: A VISION COME TRUE

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	311ZA0620X	Adult Care Home Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427236934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A VISION COME TRUE

Provider Business Mailing Address
First Line	:	220 HATCH ST
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27217-2318
Country	:	US
Telephone Number	:	336-227-4960
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 HATCH ST
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27217-2318
Country	:	US
Telephone Number	:	336-227-4960
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. JANICE REAVES
Credential	:
Telephone Number	:	336-227-4960

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	07/16/2012

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Directions to “A VISION COME TRUE ” Practice Location

Language	Start Address	Practice Location

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