Organization
VINTAGE VITALITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALTHEA HAYNES CHHP (PRACTITIONER)
(973) 704-0196
Entity
Organization
Contact information
Practice address
516 MAIN ST, EAST ORANGE, NJ 07018-2244
(973) 704-0196
Mailing address
516 MAIN ST, EAST ORANGE, NJ 07018-2244
(973) 704-0196
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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