Provider Demographics
NPI:1629684725
Name:NEW VISION BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:NEW VISION BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASHEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:330-234-5251
Mailing Address - Street 1:80 E MIDLOTHIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507-2019
Mailing Address - Country:US
Mailing Address - Phone:330-707-4636
Mailing Address - Fax:
Practice Address - Street 1:80 E MIDLOTHIAN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-2019
Practice Address - Country:US
Practice Address - Phone:330-234-5251
Practice Address - Fax:330-234-5251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0441363Medicaid