Provider Demographics
NPI:1952533408
Name:ENVISION INC
Entity Type:Organization
Organization Name:ENVISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ANNELLE
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-268-4383
Mailing Address - Street 1:4504 BRISTOL HWY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3571
Mailing Address - Country:US
Mailing Address - Phone:423-268-4383
Mailing Address - Fax:423-915-0021
Practice Address - Street 1:4504 BRISTOL HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3571
Practice Address - Country:US
Practice Address - Phone:423-952-2211
Practice Address - Fax:423-952-2210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDEPENDENT LIVING SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-18
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000008670251C00000X, 320900000X, 385HR2060X
TNPSS0000000282251J00000X
TNL000000004327253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445195Medicaid
TNE56Medicaid