Provider Demographics
NPI:1639310238
Name:VISIONS OF HOPE ADOLESCENT CENTER, INC
Entity Type:Organization
Organization Name:VISIONS OF HOPE ADOLESCENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNETTA
Authorized Official - Middle Name:SHINA
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-768-6185
Mailing Address - Street 1:3633 GLIDEWELL CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6044
Mailing Address - Country:US
Mailing Address - Phone:919-768-6185
Mailing Address - Fax:
Practice Address - Street 1:3633 GLIDEWELL CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6044
Practice Address - Country:US
Practice Address - Phone:919-768-6185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children