Healthcare Provider Details

I. General information

NPI: 1225937113
Provider Name (Legal Business Name): VITALITY COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 MORRIS ST NE STE B
ALBUQUERQUE NM
87111-3605
US

IV. Provider business mailing address

750 SHERRI CT
BOSQUE FARMS NM
87068-9770
US

V. Phone/Fax

Practice location:
  • Phone: 505-441-2344
  • Fax: 866-835-8369
Mailing address:
  • Phone: 505-615-7972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MONICA REMPEN
Title or Position: OWNER/PRESIDENT
Credential: DOM
Phone: 505-441-2344