Profound Visionz Organization LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PROFOUND VISIONZ ORGANIZATION LLC

Practice address

2300 Garrison Blvd Ste 107
Baltimore, MD 21216-2308

Phone

(410) 202-3760

NPI assigned

Aug 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tumpei Troie Pollard-Jackson

Title

Owner

Phone

(443) 254-1884

Specialties & licenses 1

Addresses

Tax ID family

Profound Visionz Organization LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Profound Visionz Organization LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
  • NPI 1669204673
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1104658111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "410-202-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "410-202-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFOUND VISIONZ ORGANIZATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A",
        "authorized_official_last_name": "POLLARD-JACKSON",
        "authorized_official_first_name": "TUMPEI",
        "authorized_official_middle_name": "TROIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-254-1884"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.