Provider Demographics
NPI:1912151275
Name:VISIONQUEST NATIONAL LTD
Entity Type:Organization
Organization Name:VISIONQUEST NATIONAL LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROSICA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-486-2280
Mailing Address - Street 1:352 MARSHALLTON THORNDALE RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2063
Mailing Address - Country:US
Mailing Address - Phone:610-486-2280
Mailing Address - Fax:610-384-7258
Practice Address - Street 1:352 MARSHALLTON THORNDALE RD
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2063
Practice Address - Country:US
Practice Address - Phone:610-486-2280
Practice Address - Fax:610-384-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA438850323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001477610-0044Medicaid