Basic Information
| Provider Information | |||||||||
| NPI: | 1790878353 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VISIONS UNLIMITED, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6833 STOCKTON BLVD | ||||||||
| Address2: | SUITES 485 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958232372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163940800 | ||||||||
| FaxNumber: | 9164297824 | ||||||||
| Practice Location | |||||||||
| Address1: | 6833 STOCKTON BLVD | ||||||||
| Address2: | SUITE 485 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958232372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163940800 | ||||||||
| FaxNumber: | 9164297824 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 01/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | BATES | ||||||||
| AuthorizedOfficialFirstName: | ROLEDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9163940800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0855X | N | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | 261QM0850X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.