Provider Demographics
NPI:1760654834
Name:MAKING VISIONS COME TRUE PLLC
Entity Type:Organization
Organization Name:MAKING VISIONS COME TRUE PLLC
Other - Org Name:UNLIMITED CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTER NURSE / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-670-5700
Mailing Address - Street 1:2018 FORT BRAGG RD STE 126A
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-7040
Mailing Address - Country:US
Mailing Address - Phone:910-485-7505
Mailing Address - Fax:910-728-4783
Practice Address - Street 1:2018 FORT BRAGG RD STE 126A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-7040
Practice Address - Country:US
Practice Address - Phone:910-485-7505
Practice Address - Fax:910-728-4783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-29
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601605Medicaid