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326 Orchard Park Rd West Seneca NY 14224-2635 | |
| (716) 828-1719 | |
| (716) 828-9275 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 326 Orchard Park Rd, West Seneca, New York |
| Authorized Official Name and Position | Bruce Nisbet (PRESIDENT/CEO) |
| Authorized Official Contact | 7166622040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
227 Thorn Ave Orchard Park NY 14127-2600 Ph: (716) 662-2040 | 326 Orchard Park Rd West Seneca NY 14224-2635 Ph: (716) 828-1719 |
| NPI Number | 1417121344 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 07/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417121344 | NPI | - | NPPES |
| 00660577 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6845304A (New York) | Primary |
Vitality Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Gardenville Pkwy W Ste 114, West Seneca, NY 14224 Phone: 716-202-8428 | |