Provider Demographics
NPI:1508099441
Name:VISIONS OF HOPE ADOLESCENT CENTER, INC
Entity Type:Organization
Organization Name:VISIONS OF HOPE ADOLESCENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAMEON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-949-3031
Mailing Address - Street 1:3633 GLIDEWELL COURT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6044
Mailing Address - Country:US
Mailing Address - Phone:919-949-3031
Mailing Address - Fax:
Practice Address - Street 1:3633 GLIDEWELL COURT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6044
Practice Address - Country:US
Practice Address - Phone:919-949-3031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health