Organization
NEW VISION SUPPORT SERVICE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WAKETA YVETTE CRAPENTER (OWNER)
(901) 319-5983
Entity
Organization
Contact information
Practice address
1331 UNION AVE, SUITE 932, MEMPHIS, TN 38104-3513
(901) 319-5983
Mailing address
1331 UNION AVE, SUITE 932, MEMPHIS, TN 38104-3513
(901) 319-5983
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
305R00000X
Preferred Provider Organization
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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