Provider Demographics
NPI:1629400411
Name:POTHI VISIONS
Entity Type:Organization
Organization Name:POTHI VISIONS
Other - Org Name:PROVISION OF THE HEARTS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MECHAC
Authorized Official - Middle Name:
Authorized Official - Last Name:TRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-709-5570
Mailing Address - Street 1:2301 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-2638
Mailing Address - Country:US
Mailing Address - Phone:954-709-5570
Mailing Address - Fax:888-709-9126
Practice Address - Street 1:1705 NW 73RD AVE
Practice Address - Street 2:APT/SUITE
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4422
Practice Address - Country:US
Practice Address - Phone:954-709-5570
Practice Address - Fax:888-709-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility