Provider Demographics
NPI:1033350855
Name:CLEAR VISION COMMUNITY SERVICES, LLC
Entity Type:Organization
Organization Name:CLEAR VISION COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELGY
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:704-576-7095
Mailing Address - Street 1:1348 EBENEZER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2727
Mailing Address - Country:US
Mailing Address - Phone:803-325-1915
Mailing Address - Fax:803-325-1927
Practice Address - Street 1:1348 EBENEZER RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2726
Practice Address - Country:US
Practice Address - Phone:803-325-1915
Practice Address - Fax:803-325-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health