Provider Demographics
NPI:1407259872
Name:VISION BUILDERS ONE, INCORPORATED
Entity Type:Organization
Organization Name:VISION BUILDERS ONE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK-BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-203-4018
Mailing Address - Street 1:4134 WORLINGTON TER
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-1335
Mailing Address - Country:US
Mailing Address - Phone:772-203-4018
Mailing Address - Fax:
Practice Address - Street 1:4134 WORLINGTON TER
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-1335
Practice Address - Country:US
Practice Address - Phone:772-203-4018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL012083300251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health