Provider Demographics
NPI:1669241873
Name:A VISION FOR YOU INC
Entity type:Organization
Organization Name:A VISION FOR YOU INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNATHAN
Authorized Official - Middle Name:LUCAS
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-498-7588
Mailing Address - Street 1:1675 STORY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1739
Mailing Address - Country:US
Mailing Address - Phone:502-749-6344
Mailing Address - Fax:
Practice Address - Street 1:1675 STORY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1739
Practice Address - Country:US
Practice Address - Phone:502-749-6344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY811959OtherKENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES - AODE