Provider Demographics
NPI:1073072682
Name:COMMUNITY VISIONS, LLC
Entity Type:Organization
Organization Name:COMMUNITY VISIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSEN-STRAIT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:716-597-6989
Mailing Address - Street 1:103 PRINCETON BLVD
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1736
Mailing Address - Country:US
Mailing Address - Phone:716-897-9861
Mailing Address - Fax:
Practice Address - Street 1:103 PRINCETON BLVD
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1736
Practice Address - Country:US
Practice Address - Phone:716-897-9861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health