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General NPI Number Information
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NPI Number | 1477711877
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Entity Type | Organization
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Legal Business Name | VITAL DECISIONS LLC
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 379 THORNALL ST FL 3
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City | EDISON
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State | NJ
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Zip | 08837-2228
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Country | US
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Telephone | 973-379-0079
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Fax |
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Provider Business Mailing Address
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Address Line | 379 THORNALL ST FL 3
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City | EDISON
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State | NJ
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Zip | 08837-2228
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Country | US
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Telephone | 973-379-0079
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MITCHELL DAITZ
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Credential |
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Telephone | 973-379-0079
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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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