Provider Demographics
NPI:1376091249
Name:VISION HEALTHCARE SERVICES,INC.
Entity Type:Organization
Organization Name:VISION HEALTHCARE SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:UKAEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:BBA, LPN
Authorized Official - Phone:443-857-4294
Mailing Address - Street 1:6600 YORK RD
Mailing Address - Street 2:STE. 206
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2092
Mailing Address - Country:US
Mailing Address - Phone:410-377-0154
Mailing Address - Fax:410-377-0130
Practice Address - Street 1:6600 YORK ROAD
Practice Address - Street 2:STE 206
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212
Practice Address - Country:US
Practice Address - Phone:410-377-0154
Practice Address - Fax:410-377-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMH-2096251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health