Provider Demographics
NPI:1740095801
Name:BIG VISION INC
Entity type:Organization
Organization Name:BIG VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUOCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:IWEALA
Authorized Official - Suffix:
Authorized Official - Credentials:CLINICIAN
Authorized Official - Phone:410-205-3120
Mailing Address - Street 1:52 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-5870
Mailing Address - Country:US
Mailing Address - Phone:667-284-8030
Mailing Address - Fax:
Practice Address - Street 1:4324 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6733
Practice Address - Country:US
Practice Address - Phone:410-205-3120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health