Provider Demographics
NPI:1952052524
Name:NEW VISION YOUTH & COMMUNITY SERVICES, INC
Entity Type:Organization
Organization Name:NEW VISION YOUTH & COMMUNITY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-884-1907
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31059-0743
Mailing Address - Country:US
Mailing Address - Phone:404-884-1907
Mailing Address - Fax:
Practice Address - Street 1:105 FIELDSTONE DR STE 107
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-7105
Practice Address - Country:US
Practice Address - Phone:404-884-1907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management