Provider Demographics
NPI:1447651070
Name:COMMUNITY VISIONS LLC
Entity type:Organization
Organization Name:COMMUNITY VISIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-229-6121
Mailing Address - Street 1:17932 FRALEY BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2456
Mailing Address - Country:US
Mailing Address - Phone:703-680-5127
Mailing Address - Fax:703-878-1202
Practice Address - Street 1:17932 FRALEY BLVD STE 205
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2456
Practice Address - Country:US
Practice Address - Phone:703-680-5127
Practice Address - Fax:703-878-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1305-01-001261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center