Provider Demographics
NPI:1194047662
Name:UNLIMITED VISIONS AFTERCARE, INC
Entity type:Organization
Organization Name:UNLIMITED VISIONS AFTERCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EXECUTIVEOFFICER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:713-921-2276
Mailing Address - Street 1:5527 LAWNDALE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-3818
Mailing Address - Country:US
Mailing Address - Phone:713-921-2276
Mailing Address - Fax:713-921-7466
Practice Address - Street 1:5527 LAWNDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-3818
Practice Address - Country:US
Practice Address - Phone:713-921-2276
Practice Address - Fax:713-921-7466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1661-A261QR0405X
TX1661-B261QR0405X
TX161-31213245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161-3121OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX1661-BOtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX1661-AOtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES