Provider Demographics
NPI:1548307937
Name:VISIONS ADOLESCENCE CARE FACILITY, INC
Entity type:Organization
Organization Name:VISIONS ADOLESCENCE CARE FACILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:336-342-1136
Mailing Address - Street 1:1060 N SCALES ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-2224
Mailing Address - Country:US
Mailing Address - Phone:336-342-1636
Mailing Address - Fax:336-342-1196
Practice Address - Street 1:1060 N SCALES ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-2224
Practice Address - Country:US
Practice Address - Phone:336-342-1636
Practice Address - Fax:336-342-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-079-062320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness