Provider Demographics
NPI:1073984316
Name:A VALLEY OF VISIONS, LLC
Entity Type:Organization
Organization Name:A VALLEY OF VISIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:252-642-5345
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:COLERAIN
Mailing Address - State:NC
Mailing Address - Zip Code:27924-0134
Mailing Address - Country:US
Mailing Address - Phone:252-642-5345
Mailing Address - Fax:
Practice Address - Street 1:307 MAIN ST E
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3419
Practice Address - Country:US
Practice Address - Phone:252-642-5345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health