# VITAL INTEGRATIVE SOLUTIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225719677
- **Authorized official:** DR. TINA WILLIAMS DNP, CNM, FNP, PMHNP (CEO/OWNER/OPERATOR)
- **Authorized official phone:** (336) 253-8252

## Contact information

- **Practice address:** 901 CUSTER AVE SE, ATLANTA, GA 30316
- **Practice address phone:** (404) 939-2772
- **Mailing address:** 650 PONCE DE LEON AVE NE STE 300, ATLANTA, GA 30308-1864
- **Mailing address phone:** (404) 939-2772

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP1700X | Perinatal Nurse Practitioner | — | NULL | — |
| 363LP1700X | Perinatal Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/28/2023
- **Last updated:** 07/28/2023