Provider Demographics
NPI:1619174786
Name:ONE OF OUR OWN, LLC
Entity Type:Organization
Organization Name:ONE OF OUR OWN, LLC
Other - Org Name:VISIONS IN ACTION
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-658-1506
Mailing Address - Street 1:7003 MECHANICSVILLE TPKE
Mailing Address - Street 2:SUITE 1111
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-7100
Mailing Address - Country:US
Mailing Address - Phone:804-658-1506
Mailing Address - Fax:866-217-8718
Practice Address - Street 1:3921 MONTCLAIR RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1146
Practice Address - Country:US
Practice Address - Phone:804-658-1506
Practice Address - Fax:866-217-8718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VASS-358-07322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children