# VITALITY AGELESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vitality Ageless Center LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730657271
- **Authorized official:** JULIE YU (OWNER)
- **Authorized official phone:** (770) 614-6266

## Contact information

- **Practice address:** VITALITY AGELESS CENTER LLC, 1300 PEACHTREE INDUSTRIAL BLVD \#1201, SUWANEE, GA 30024-4686
- **Practice address phone:** (770) 614-6266
- **Practice address fax:** (770) 623-9949
- **Mailing address:** 1300 PEACHTREE INDUSTRIAL BLVD STE 1201, SUWANEE, GA 30024-4550
- **Mailing address phone:** (770) 614-6266
- **Mailing address fax:** (770) 623-9949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 11/02/2018
- **Last updated:** 05/09/2024