Organization Active NPI

Profound Visionz Organization LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1669204673
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
PROFOUND VISIONZ ORGANIZATION LLC
Practice address
2300 Garrison Blvd Ste 107
Baltimore, MD 21216-2308
Phone
(410) 202-3760
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Ms. Tumpei Trioe Pollard-Jackson
Title
Owner
Phone
(443) 254-1884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2300 Garrison Blvd Ste 107
Baltimore, MD 21216-2308

Mailing address

2300 Garrison Blvd Ste 107
Baltimore, MD 21216-2308
Phone (410) 202-3760

National Provider Directory

National Provider Directory
Tax ID family
Profound Visionz Organization LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1669204673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "410-202-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "410-202-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFOUND VISIONZ ORGANIZATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A",
        "authorized_official_last_name": "POLLARD-JACKSON",
        "authorized_official_first_name": "TUMPEI",
        "authorized_official_middle_name": "TRIOE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-254-1884",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.