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General NPI Number Information
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NPI Number | 1083385777
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Entity Type | Organization
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Legal Business Name | VITA HEALTH SERVICES, LLPC
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 4 SCIENCE PARK C/O NELS
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 844-830-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SCIENCE PARK C/O NELS
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 844-830-7233
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LYNN HAMILTON
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Credential |
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Telephone | 844-830-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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