# GIFTED VISIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568611440
- **Authorized official:** MRS. SHANICKA PORTER (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (919) 803-9392

## Contact information

- **Practice address:** 148 CARRIE DR, CLAYTON, NC 27527-5731
- **Practice address phone:** (919) 585-6130
- **Practice address fax:** (919) 585-6130
- **Mailing address:** 2532 MAYBROOK CROSSING DR, RALEIGH, NC 27610-3296
- **Mailing address phone:** (919) 803-9392
- **Mailing address fax:** (919) 585-6130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-051-166 | NC | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-051-167 | NC | Yes |

## Other

- **Enumeration date:** 09/16/2008
- **Last updated:** 09/23/2008