Vision Personal Care Home, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

011-01-105-1 Issued in GA

Legal business name

VISION PERSONAL CARE HOME, INC.

Practice address

960 Curry PL
Macon, GA 31211-1804

Phone

(478) 750-4401

Fax

(478) 746-7774

NPI assigned

Jan 15, 2008

Organization subpart

No

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

Authorized official

Name

Shandriyel Marie Ben

Title

Owner/Administrator

Phone

(504) 270-4439

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1225214760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312020518",
            "telephone_number": "478-750-4401",
            "fax_number": "478-746-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 CURRY PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111804",
            "telephone_number": "478-750-4401",
            "fax_number": "478-746-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION PERSONAL CARE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "BEN",
        "authorized_official_first_name": "SHANDRIYEL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "504-270-4439"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "011-01-105-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.