Provider Demographics
NPI:1295428282
Name:ENVISIONS YOUTH & FAMILY SERVICES, LLC
Entity type:Organization
Organization Name:ENVISIONS YOUTH & FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATARSHA
Authorized Official - Middle Name:SHANTA
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-450-5854
Mailing Address - Street 1:4433 GODWIN BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6927
Mailing Address - Country:US
Mailing Address - Phone:757-450-5854
Mailing Address - Fax:866-871-5839
Practice Address - Street 1:4433 GODWIN BLVD STE E
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6927
Practice Address - Country:US
Practice Address - Phone:757-450-5854
Practice Address - Fax:866-871-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health