Provider Demographics
NPI:1518384106
Name:VISIONS OF LIFE BEHAVIORAL HEALTH SERVICES, INCORPORATED
Entity Type:Organization
Organization Name:VISIONS OF LIFE BEHAVIORAL HEALTH SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL-OBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-389-1337
Mailing Address - Street 1:754 CHAPMAN STREET
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238
Mailing Address - Country:US
Mailing Address - Phone:678-389-1337
Mailing Address - Fax:
Practice Address - Street 1:754 CHAPMAN STREET
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238
Practice Address - Country:US
Practice Address - Phone:678-389-1337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty