Provider Demographics
NPI:1073950879
Name:VITALITY UNLIMITED
Entity Type:Organization
Organization Name:VITALITY UNLIMITED
Other - Org Name:SILVER SAGE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:775-738-4158
Mailing Address - Street 1:530 MELARKEY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3168
Mailing Address - Country:US
Mailing Address - Phone:775-623-3626
Mailing Address - Fax:775-623-1913
Practice Address - Street 1:530 MELARKEY ST STE 206
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3168
Practice Address - Country:US
Practice Address - Phone:775-623-3626
Practice Address - Fax:775-623-1913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITALITY UNLIMITED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder