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Contact Information

VITALIS WELLNESS CENTER OF PHOENIX, AZ PC
1910 S STAPLEY DR STE 120
MESA, AZ85204-6676
 Phone: 800-922-1873
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Brain Injury Medicine

2084P0301X 86 Physician/Neuropsychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for VITALIS WELLNESS CENTER OF PHOENIX, AZ PC

NPI Number 1497421101
LBN Legal business name VITALIS WELLNESS CENTER OF PHOENIX, AZ PC
Authorized official NELLIE SAMUEL - (CO-OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/22/2021
Last updated 07/19/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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