Provider Demographics
NPI:1851689509
Name:VISIONS AMERICA COMMUNITY DEVELOPMENT CORP.
Entity Type:Organization
Organization Name:VISIONS AMERICA COMMUNITY DEVELOPMENT CORP.
Other - Org Name:VISION AMERICA C.D.C. HEALTHCARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-901-9131
Mailing Address - Street 1:P.O. BOX 1334
Mailing Address - Street 2:401 WASHINGTON, ST
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613
Mailing Address - Country:US
Mailing Address - Phone:410-901-9131
Mailing Address - Fax:410-228-0706
Practice Address - Street 1:401 WASHINGTON ST
Practice Address - Street 2:403 WASHINGTON ST.
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2809
Practice Address - Country:US
Practice Address - Phone:410-901-9131
Practice Address - Fax:410-228-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2890251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health