Invision Management Corporation

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL042039 Issued in NC

Legal business name

INVISION MANAGEMENT CORPORATION

Practice address

4852 US Highway 158
Roanoke Rapids, NC 27870-8948

Phone

(252) 535-1192

Fax

(252) 535-1147

NPI assigned

Dec 14, 2007

Last updated

Dec 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Paula Douglass, MALT, BA

Title

Ceo

Phone

(443) 460-2374

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• A Second Chance Other name

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1275716045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4852 US HIGHWAY 158",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278708948",
            "telephone_number": "252-535-1192",
            "fax_number": "252-535-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4852 US HIGHWAY 158",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278708948",
            "telephone_number": "252-535-1192",
            "fax_number": "252-535-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INVISION MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PAULA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-460-2374",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MALT, BA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL042039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603561",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H63008",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Second Chance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.