Provider Demographics
NPI:1942071683
Name:VITALITY UNLIMITED
Entity Type:Organization
Organization Name:VITALITY UNLIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:775-738-4158
Mailing Address - Street 1:1135 TERMINAL WAY STE 208B
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2168
Mailing Address - Country:US
Mailing Address - Phone:775-322-3668
Mailing Address - Fax:775-738-2122
Practice Address - Street 1:1135 TERMINAL WAY STE 208B
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2168
Practice Address - Country:US
Practice Address - Phone:775-322-3668
Practice Address - Fax:775-738-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health