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General NPI Number Information
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NPI Number | 1548011604
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Entity Type | Organization
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Legal Business Name | URBAN VITALITY SOLUTIONS
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 1400 W LOMBARD ST STE 1053
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City | BALTIMORE
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State | MD
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Zip | 21223-3134
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Country | US
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Telephone | 443-904-8336
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Fax |
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Provider Business Mailing Address
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Address Line | 7201 ALDEN WAY UNIT 2018
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City | HANOVER
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State | MD
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Zip | 21076-2478
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Country | US
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Telephone | 443-904-8336
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Fax |
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Authorized Official
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Title or Position | CO OWNER
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Name | TACARIA GARDNER
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Credential |
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Telephone | 443-904-8336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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