Provider Demographics
NPI:1770248403
Name:VITA SANA WELLNESS PARTNERS LLC
Entity type:Organization
Organization Name:VITA SANA WELLNESS PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-406-8372
Mailing Address - Street 1:PO BOX 692649
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02269-2649
Mailing Address - Country:US
Mailing Address - Phone:617-406-8372
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON PL
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4407
Practice Address - Country:US
Practice Address - Phone:617-406-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITA SANA WELLNESS PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty