Organization
VITAL WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARINE YAZIDZHYAN (MEMBER)
(602) 635-4192
Entity
Organization
Contact information
Practice address
3150 N 24TH ST STE A202, PHOENIX, AZ 85016-7354
(602) 635-4192
(602) 635-4193
Mailing address
3150 N 24TH ST STE A202, PHOENIX, AZ 85016-7354
(602) 635-4192
(602) 635-4193
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
09/19/2024
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