Provider Demographics
NPI:1760107239
Name:VITAL MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:VITAL MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:NJOROGE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:617-820-4541
Mailing Address - Street 1:150 LAKEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-1445
Mailing Address - Country:US
Mailing Address - Phone:617-820-4541
Mailing Address - Fax:
Practice Address - Street 1:150 LAKEHURST AVE
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-1445
Practice Address - Country:US
Practice Address - Phone:617-820-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty