| Vital Wellness Center Llc | |
|
3150 N 24th St Ste A202 Phoenix AZ 85016-7354 | |
| (602) 635-4192 | |
| (602) 635-4193 |
| Full Name | Vital Wellness Center Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 3150 N 24th St Ste A202, Phoenix, Arizona |
| Authorized Official Name and Position | Karine Yazidzhyan (MEMBER) |
| Authorized Official Contact | 6026354192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Wellness Center Llc 3150 N 24th St Ste A202 Phoenix AZ 85016-7354 Ph: (602) 635-4192 | Vital Wellness Center Llc 3150 N 24th St Ste A202 Phoenix AZ 85016-7354 Ph: (602) 635-4192 |
| NPI Number | 1235815333 |
|---|---|
| Provider Enumeration Date | 06/23/2023 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235815333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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