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Organization
VITAL INTEGRATIVE SOLUTIONS LLC
Active
Organization
VITAL INTEGRATIVE SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA WILLIAMS DNP, CNM, FNP, PMHNP (CEO/OWNER/OPERATOR)
(336) 253-8252
Entity
Organization
Contact information
Practice address
901 CUSTER AVE SE, ATLANTA, GA 30316
(404) 939-2772
Mailing address
650 PONCE DE LEON AVE NE STE 300, ATLANTA, GA 30308-1864
(404) 939-2772
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP1700X
Perinatal Nurse Practitioner
—
NULL
363LP1700X
Perinatal Nurse Practitioner
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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