Provider Demographics
NPI:1255823753
Name:VITAL TREATMENT AND RECOVERY CENTERS, INC
Entity type:Organization
Organization Name:VITAL TREATMENT AND RECOVERY CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:RAZA
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-482-5159
Mailing Address - Street 1:10467 MORNING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-3211
Mailing Address - Country:US
Mailing Address - Phone:951-379-1195
Mailing Address - Fax:
Practice Address - Street 1:10467 MORNING RIDGE DR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-3211
Practice Address - Country:US
Practice Address - Phone:951-379-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility