| Envision One Outpatient Services, Llc | |
|
15 Goodrich Ave Petersburg VA 23805-2119 | |
| (804) 862-8300 | |
| (804) 862-8302 |
| Full Name | Envision One Outpatient Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 15 Goodrich Ave, Petersburg, Virginia |
| Authorized Official Name and Position | Angela Jones (PRESIDENT/CEO) |
| Authorized Official Contact | 8048628300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Envision One Outpatient Services, Llc 15 Goodrich Ave Petersburg VA 23805-2119 Ph: (804) 862-8300 | Envision One Outpatient Services, Llc 15 Goodrich Ave Petersburg VA 23805-2119 Ph: (804) 862-8300 |
| NPI Number | 1336542596 |
|---|---|
| Provider Enumeration Date | 10/02/2014 |
| Last Update Date | 11/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336542596 | NPI | - | NPPES |
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