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General NPI Number Information
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NPI Number | 1437453990
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Entity Type | Organization
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Legal Business Name | THE VIGOR CONSORTIUM
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Dates
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Enumeration Date | 12/27/2010
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 1230 PEACHTREE ST SUITE 1800
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City | ATLANTA
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State | GA
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Zip | 30309-3574
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Country | US
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Telephone | 404-538-4945
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Fax |
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Provider Business Mailing Address
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Address Line | 1230 PEACHTREE ST SUITE 1800
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City | ATLANTA
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State | GA
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Zip | 30309-3574
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ERIC ALLEN
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Credential | MBA PH
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Telephone | 404-538-4945
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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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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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