Provider Demographics
NPI:1407311962
Name:VISION HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:VISION HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:PEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DJOKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-716-9192
Mailing Address - Street 1:5516 GOLDEN EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-6750
Mailing Address - Country:US
Mailing Address - Phone:202-716-9192
Mailing Address - Fax:
Practice Address - Street 1:3908 CHERRY HILL WAY
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2219
Practice Address - Country:US
Practice Address - Phone:202-716-9192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities