Provider Demographics
NPI:1992827810
Name:NEW VISION
Entity type:Organization
Organization Name:NEW VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:WOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-621-9721
Mailing Address - Street 1:8 CRITE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5546
Mailing Address - Country:US
Mailing Address - Phone:336-317-9226
Mailing Address - Fax:336-621-9721
Practice Address - Street 1:8 CRITE CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5546
Practice Address - Country:US
Practice Address - Phone:336-317-9226
Practice Address - Fax:336-621-9721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFLC041035310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility