Organization
VITAL INC.
Active
Other names
Vital Living Network
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALPHONSO WHITFIELD III (PRESIDENT)
(229) 588-0075
Entity
Organization
Contact information
Practice address
2910 TARA DR APT 321, VALDOSTA, GA 31602-1478
(229) 588-0075
Mailing address
2910 TARA DR APT 321, VALDOSTA, GA 31602-1478
(229) 588-0075
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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