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General NPI Number Information
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NPI Number | 1396567939
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Entity Type | Organization
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Legal Business Name | VITALITY UNLIMITED
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 6402 MCLEOD DR STE 4AND5
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City | LAS VEGAS
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State | NV
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Zip | 89120-4405
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Country | US
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Telephone | 775-738-4158
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Fax | 775-778-9501
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Provider Business Mailing Address
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Address Line | PO BOX 2580
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City | ELKO
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State | NV
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Zip | 89803-2580
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Country | US
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Telephone | 775-738-4158
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Fax | 775-778-9501
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DOROTHY J DEXTER
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Credential | MBA
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Telephone | 775-738-4158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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License Number State |
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