Organization
VITAL MIND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBUNOLUWA LAWAL (CEO)
(703) 980-0478
Entity
Organization
Contact information
Practice address
525 EASTERN AVE STE B3, FAIRMOUNT HEIGHTS, MD 20743-1677
(703) 980-0478
Mailing address
525 EASTERN AVE STE B3, FAIRMOUNT HEIGHTS, MD 20743-1677
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
02/09/2024
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