New Vision Group Home

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

NEW VISION GROUP HOME

Practice address

919 Rencher St
Clovis, NM 88101-5858

Phone

(505) 769-2142

Fax

(505) 769-2161

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Evan Baker

Title

Co-Owner

Phone

(505) 769-2142

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497872550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 RENCHER ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015858",
            "telephone_number": "505-769-2142",
            "fax_number": "505-769-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 RENCHER ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015858",
            "telephone_number": "505-769-2142",
            "fax_number": "505-769-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW VISION GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "505-769-2142"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04937261",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Clovis, NM by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.