Provider Demographics
NPI:1114290608
Name:SUCCESSFUL VISIONS LLC
Entity Type:Organization
Organization Name:SUCCESSFUL VISIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-255-8279
Mailing Address - Street 1:1030 ALAMANCE COURT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3806
Mailing Address - Country:US
Mailing Address - Phone:336-255-8279
Mailing Address - Fax:336-217-8842
Practice Address - Street 1:1030 ALAMANCE COURT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3806
Practice Address - Country:US
Practice Address - Phone:336-255-8279
Practice Address - Fax:336-217-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health