Provider Demographics
NPI:1083358295
Name:NEW VISION HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:NEW VISION HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHATONIA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-E
Authorized Official - Phone:757-701-6444
Mailing Address - Street 1:899 OLD CLUBHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-3082
Mailing Address - Country:US
Mailing Address - Phone:757-701-6444
Mailing Address - Fax:
Practice Address - Street 1:899 OLD CLUBHOUSE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-3082
Practice Address - Country:US
Practice Address - Phone:757-701-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty