Provider Demographics
NPI:1508963281
Name:FUTURE VISIONS FOUNDATION INC
Entity Type:Organization
Organization Name:FUTURE VISIONS FOUNDATION INC
Other - Org Name:DBA HARRISON OPTIMAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAULE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-741-9596
Mailing Address - Street 1:PO BOX 1670
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602-1670
Mailing Address - Country:US
Mailing Address - Phone:870-741-9596
Mailing Address - Fax:870-741-9687
Practice Address - Street 1:6302 A HILLSIDE LANE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601
Practice Address - Country:US
Practice Address - Phone:870-741-9896
Practice Address - Fax:870-741-9687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty