Provider Demographics
NPI:1043714900
Name:VISION RECOVERY CENTER INC
Entity type:Organization
Organization Name:VISION RECOVERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:YESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:ORT/L, SCLV
Authorized Official - Phone:702-966-2020
Mailing Address - Street 1:9191 W FLAMINGO RD STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6859
Mailing Address - Country:US
Mailing Address - Phone:702-476-0871
Mailing Address - Fax:702-570-5681
Practice Address - Street 1:9191 W FLAMINGO RD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6859
Practice Address - Country:US
Practice Address - Phone:702-476-0871
Practice Address - Fax:702-570-5681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV885152W00000X
NV1047944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty