Provider Demographics
NPI:1992939474
Name:VIZION ONE, INC
Entity type:Organization
Organization Name:VIZION ONE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDALLAH
Authorized Official - Middle Name:SULEMAN
Authorized Official - Last Name:KITWARA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:202-545-0211
Mailing Address - Street 1:1237 GALLATIN ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2856
Mailing Address - Country:US
Mailing Address - Phone:202-545-0211
Mailing Address - Fax:240-751-4156
Practice Address - Street 1:1237 GALLATIN ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2856
Practice Address - Country:US
Practice Address - Phone:202-545-0211
Practice Address - Fax:240-751-4156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDCJM-2008-HC-0001-06315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC039252900Medicaid