Provider Demographics
NPI:1649468588
Name:INNOVISIONS FOR FAMILIES, LLC
Entity type:Organization
Organization Name:INNOVISIONS FOR FAMILIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, EXEC. DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CCDVC, CAMS
Authorized Official - Phone:678-768-9211
Mailing Address - Street 1:PO BOX 724825
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31139-1825
Mailing Address - Country:US
Mailing Address - Phone:678-768-9211
Mailing Address - Fax:770-919-7365
Practice Address - Street 1:1254 CONCORD RD SE STE 105
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4371
Practice Address - Country:US
Practice Address - Phone:678-768-9211
Practice Address - Fax:770-919-7365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health