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General NPI Number Information
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NPI Number | 1235095548
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Entity Type | Organization
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Legal Business Name | VITALA HEALTHCARE, LLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 15446 N GREENWAY HAYDEN LOOP UNIT 2019
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3098
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Country | US
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Telephone | 781-215-4596
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Fax |
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Provider Business Mailing Address
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Address Line | 15446 N GREENWAY HAYDEN LOOP UNIT 2019
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3098
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Country | US
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Telephone | 781-215-4596
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. PHYLLIS WAIGWA
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Credential | RN
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Telephone | 781-215-4596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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Taxonomy #5
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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Taxonomy #6
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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Taxonomy #7
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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