Vital Wellness Center LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

VITAL WELLNESS CENTER LLC

Practice address

3150 N 24TH St Ste A202
Phoenix, AZ 85016-7354

Phone

(602) 635-4192

Fax

(602) 635-4193

NPI assigned

Jun 23, 2023

Last updated

Sep 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karine Yazidzhyan

Title

Member

Phone

(602) 635-4192

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1235815333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N 24TH ST STE A202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167354",
            "telephone_number": "602-635-4192",
            "fax_number": "602-635-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N 24TH ST STE A202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167354",
            "telephone_number": "602-635-4192",
            "fax_number": "602-635-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "YAZIDZHYAN",
        "authorized_official_first_name": "KARINE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-635-4192"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Andrew Vitagliano, PA-C
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• Vitalab Pharmacy Inc (Vasco Rx)
• Vitalab Pharmacy Inc (Vasco Rx)
• Vitalant
• Nicole Vitale

• Substance Use Disorder Rehabilitation Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.