# VITALITY COMMUNITY CARE CENTER

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

## Provider details

- **NPI number:** 1699516401
- **Authorized official:** DR. LATONYA CARROLL DNP (PRESIDENT)
- **Authorized official phone:** (614) 644-3331

## Contact information

- **Practice address:** 2686 CROSSROADS PLAZA DR, COLUMBUS, OH 43219-3442
- **Practice address phone:** (614) 664-3331
- **Mailing address:** 1391 W 5TH AVE \# 241, COLUMBUS, OH 43212-2902
- **Mailing address phone:** (614) 664-3331
- **Mailing address fax:** (888) 831-0965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 06/05/2024
- **Last updated:** 06/05/2024