Provider Demographics
NPI:1568185486
Name:VITA THERAPY AND CLINICAL CENTER PLLC
Entity Type:Organization
Organization Name:VITA THERAPY AND CLINICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-S
Authorized Official - Phone:956-459-6879
Mailing Address - Street 1:2301 QUAIL TRL
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-9020
Mailing Address - Country:US
Mailing Address - Phone:956-410-1447
Mailing Address - Fax:
Practice Address - Street 1:2301 QUAIL TRL
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-9020
Practice Address - Country:US
Practice Address - Phone:956-410-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty