Provider Demographics
NPI:1013207901
Name:VIZION ONE INC
Entity Type:Organization
Organization Name:VIZION ONE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXERCUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ABDALLAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KITWARA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:202-725-0772
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE 126
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2801
Mailing Address - Country:US
Mailing Address - Phone:763-200-9237
Mailing Address - Fax:763-400-4899
Practice Address - Street 1:1821 UNIVERSITY AVE W STE 126
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2801
Practice Address - Country:US
Practice Address - Phone:763-200-9237
Practice Address - Fax:763-400-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN000Medicare PIN