Healthcare Provider Details

I. General information

NPI: 1922942200
Provider Name (Legal Business Name): VITAL FIRST RESPONSE TEAM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10357 AURORA CT
FISHERS IN
46038-5510
US

IV. Provider business mailing address

10357 AURORA CT
FISHERS IN
46038-5510
US

V. Phone/Fax

Practice location:
  • Phone: 646-920-8648
  • Fax:
Mailing address:
  • Phone: 646-920-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HESHAM WANAS
Title or Position: CEO
Credential:
Phone: 646-920-8648