Organization
VITALITY COMMUNITY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATONYA CARROLL DNP (PRESIDENT)
(614) 644-3331
Entity
Organization
Contact information
Practice address
2686 CROSSROADS PLAZA DR, COLUMBUS, OH 43219-3442
(614) 664-3331
Mailing address
1391 W 5TH AVE # 241, COLUMBUS, OH 43212-2902
(614) 664-3331
(888) 831-0965
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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