Provider Demographics
NPI:1255610929
Name:VIZION ONE
Entity type:Organization
Organization Name:VIZION ONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-724-9995
Mailing Address - Street 1:10925 DAVID TAYLOR DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1040
Mailing Address - Country:US
Mailing Address - Phone:704-724-9995
Mailing Address - Fax:
Practice Address - Street 1:10925 DAVID TAYLOR DR STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1040
Practice Address - Country:US
Practice Address - Phone:704-724-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health