| Vesta, Inc. | |
|
1202 Annapolis Rd Suite F Odenton MD 21113-1387 | |
| (240) 296-1370 | |
| (410) 672-2869 |
| Full Name | Vesta, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1202 Annapolis Rd, Odenton, Maryland |
| Authorized Official Name and Position | Jignesh Dalal (CEO) |
| Authorized Official Contact | 2402966099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vesta, Inc. 9301 Annapolis Rd Suite 300 Lanham MD 20706-3125 Ph: (240) 296-5848 | Vesta, Inc. 1202 Annapolis Rd Suite F Odenton MD 21113-1387 Ph: (240) 296-1370 |
| NPI Number | 1275744757 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 05/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275744757 | NPI | - | NPPES |
| 1207504600 | Medicaid | MD | |
| 949L | Other | MD | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 14370 (Maryland) | Primary |
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