NPIMap

Organization Active NPI

Vital Health Management

  • Community/Behavioral Health Agency
  • Detroit, MI
National Provider Identifier
1083396816
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VITAL HEALTH MANAGEMENT
Practice address
17950 Woodward Ave
Detroit, MI 48203-2260
Phone
(313) 815-8908
NPI assigned
Aug 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vincent Atchison
Title
Ceo
Phone
(313) 815-8908

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

17950 Woodward Ave
Detroit, MI 48203-2260

Mailing address

17950 Woodward Ave
Detroit, MI 48203-2260
Phone (313) 815-8908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231229001244 MI Part B Supplier - Clinic/Group Practice 3971953118 Receives reassigned benefits from 12 practitioners
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1083396816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17950 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482032260",
            "telephone_number": "313-815-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17950 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482032260",
            "telephone_number": "313-815-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL HEALTH MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "ATCHISON",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-815-8908"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.