Provider Demographics
NPI:1215647607
Name:NEW VISION MENTAL HEALTH INC
Entity type:Organization
Organization Name:NEW VISION MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER (PMHNP)
Authorized Official - Prefix:
Authorized Official - First Name:KAIBEH
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:651-398-4820
Mailing Address - Street 1:7360 159TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-6618
Mailing Address - Country:US
Mailing Address - Phone:651-398-4820
Mailing Address - Fax:
Practice Address - Street 1:6014 LAKELAND AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55428-2984
Practice Address - Country:US
Practice Address - Phone:651-398-4820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty