Healthcare Provider Details

I. General information

NPI: 1790995017
Provider Name (Legal Business Name): VESTA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8141 TELEGRAPH RD
SEVERN MD
21144-3256
US

IV. Provider business mailing address

9301 ANNAPOLIS RD STE 300 ATTN: FINANCE DEPARTMENT
LANHAM MD
20706-3125
US

V. Phone/Fax

Practice location:
  • Phone: 240-296-1370
  • Fax: 410-672-2869
Mailing address:
  • Phone: 240-296-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number4567
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number4627
License Number StateMD

VIII. Authorized Official

Name: MR. JIGNESH DALAL
Title or Position: CEO
Credential: CPA
Phone: 240-296-6099