Provider Demographics
NPI:1144686965
Name:VISIONS COMMUNITY SERVICES,LLC
Entity type:Organization
Organization Name:VISIONS COMMUNITY SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:EULAMAE
Authorized Official - Middle Name:RUTLEDGE
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-965-3200
Mailing Address - Street 1:370 CLEVELAND PL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6529
Mailing Address - Country:US
Mailing Address - Phone:757-965-3200
Mailing Address - Fax:757-965-3201
Practice Address - Street 1:370 CLEVELAND PL
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6529
Practice Address - Country:US
Practice Address - Phone:757-965-3200
Practice Address - Fax:757-965-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA60802006320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0102798615Medicaid