Provider Demographics
NPI:1255952305
Name:VISIONS OF HUE, LLC
Entity type:Organization
Organization Name:VISIONS OF HUE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PREMPEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-332-6699
Mailing Address - Street 1:15427 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-3383
Mailing Address - Country:US
Mailing Address - Phone:602-332-6699
Mailing Address - Fax:
Practice Address - Street 1:11826 W LUPINE AVE
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-5050
Practice Address - Country:US
Practice Address - Phone:602-332-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities