Healthcare Provider Details

I. General information

NPI: 1467373340
Provider Name (Legal Business Name): VITALITY GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CLEMENTEL DR
DURHAM CT
06422-1102
US

IV. Provider business mailing address

14 CLEMENTEL DR
DURHAM CT
06422-1102
US

V. Phone/Fax

Practice location:
  • Phone: 866-248-8359
  • Fax:
Mailing address:
  • Phone: 866-248-8359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: MS. SHANNON JENSEN
Title or Position: HEALTH COACH EDUCATOR
Credential: CHES
Phone: 866-248-8359