| Vital Health And Wellness Clinic | |
|
5540 W Glendale Ave Ste A103 Glendale AZ 85301-2579 | |
| (602) 825-1613 | |
| Not Available |
| Full Name | Vital Health And Wellness Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5540 W Glendale Ave Ste A103, Glendale, Arizona |
| Authorized Official Name and Position | Theophilus Akoh (OWNER) |
| Authorized Official Contact | 7753357450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Health And Wellness Clinic 5540 W Glendale Ave Ste A103 Glendale AZ 85301-2579 Ph: () - | Vital Health And Wellness Clinic 5540 W Glendale Ave Ste A103 Glendale AZ 85301-2579 Ph: (602) 825-1613 |
| NPI Number | 1750030185 |
|---|---|
| Provider Enumeration Date | 03/22/2022 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750030185 | NPI | - | NPPES |
| OTC12109 | Other | AZ | AZDHS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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