Envisionlifeservices,LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

ENVISIONLIFESERVICES,LLC

Practice address

404 El Destinado Dr
Tallahassee, FL 32312-1607

Phone

(850) 510-0915

NPI assigned

Apr 20, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Philander Carol Head

Title

Owner

Phone

(850) 510-0915

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1265966857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323020105",
            "telephone_number": "850-510-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 EL DESTINADO DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121607",
            "telephone_number": "850-510-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISIONLIFESERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "PHILANDER",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-510-0915",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.