| Vesta, Inc. | |
|
22 Industrial Park Dr Ste A Waldorf MD 20602-2792 | |
| (240) 296-6030 | |
| Not Available |
| Full Name | Vesta, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 22 Industrial Park Dr Ste A, Waldorf, 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 Ste 300 Lanham MD 20706-3125 Ph: (240) 296-1379 | Vesta, Inc. 22 Industrial Park Dr Ste A Waldorf MD 20602-2792 Ph: (240) 296-6030 |
| NPI Number | 1609356575 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 08/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609356575 | NPI | - | NPPES |
| 260991608 | Medicaid | MA | |
| 949L | Other | MD | MEDICARE |
| 640570300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 14368 (Maryland) | Primary |
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