Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
VITALIS WELLNESS CENTER OF PHOENIX, AZ PC
Active
Organization
VITALIS WELLNESS CENTER OF PHOENIX, AZ PC
Active
Other names
Vitalis Wellness Center, AZ PC
Organization subpart
No
Provider details
NPI number
Authorized official
NELLIE IDARA SAMUEL DNP (CO-OWNER)
(800) 922-1873
Entity
Organization
Contact information
Practice address
1910 S STAPLEY DR STE 120, MESA, AZ 85204-6676
(800) 922-1873
Mailing address
1910 S STAPLEY DR STE 120, MESA, AZ 85204-6676
(800) 922-1873
Taxonomy
Speciality
Code
Description
License number
State
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
08/22/2021
Last updated
07/19/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers