NPIMap

Organization Active NPI

Home of New Vision

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ann Arbor, MI
National Provider Identifier
1457565202
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
810265 Issued in MI
Legal business name
HOME OF NEW VISION
Practice address
3115 Professional Drive
Ann Arbor, MI 48104
Phone
(734) 975-1602
Fax
(734) 975-1604
NPI assigned
May 10, 2007
Last updated
Jun 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Ms. Glynis A Anderson, LLMSW
Title
Ceo
Phone
(734) 975-1602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 810265 MI Primary

Addresses

Primary practice location

3115 Professional Drive
Ann Arbor, MI 48104

Mailing address

3115 Professional Drive
Ann Arbor, MI 48104
Phone (734) 975-1602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131114001859 MI Part B Supplier - Clinic/Group Practice 6901032218 Receives reassigned benefits from 3 practitioners
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

3115 Professional Dr
Ann Arbor, MI 48104
Phone (734) 975-1602

3800 Packard St
Ste 210
Ann Arbor, MI 48108
Phone (734) 975-1602

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1457565202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 PROFESSIONAL DRIVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-975-1602",
            "fax_number": "734-975-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 PROFESSIONAL DRIVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-975-1602",
            "fax_number": "734-975-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME OF NEW VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "GLYNIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-975-1602",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MI",
            "license": "810265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.