Provider Demographics
NPI:1386211456
Name:FAMILY VISIONS,LLC
Entity Type:Organization
Organization Name:FAMILY VISIONS,LLC
Other - Org Name:FAMILY VISIONS OUTPATIENT MENTAL HEALTH CENTER, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-865-5549
Mailing Address - Street 1:1515 REISTERSTOWN RD STE 310
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3815
Mailing Address - Country:US
Mailing Address - Phone:443-865-5549
Mailing Address - Fax:
Practice Address - Street 1:1515 REISTERSTOWN RD STE 310
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3815
Practice Address - Country:US
Practice Address - Phone:443-865-5549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY VISIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-08
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)