Vitality Youth Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

VITALITY YOUTH SERVICES, LLC

Practice address

726 12TH Ave
Monroe, WI 53566-1435

Phone

(608) 293-0014

NPI assigned

May 27, 2020

Organization subpart

No

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

Authorized official

Name

Ashlee Rae Glowacki, MANPI 1699492496

Title

Owner

Phone

(608) 293-0014

Specialties & licenses 2

Addresses

Practitioners 1

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

• Ashlee Rae Glowacki, MA

  • Rehabilitation Counselor
  • Monroe, WI
  • NPI 1699492496
  NPD Authorized official

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1346863180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 12TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661435",
            "telephone_number": "608-293-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 12TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661435",
            "telephone_number": "608-293-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY YOUTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "GLOWACKI",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-293-0014",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Verber, PHARMD
• Tamara Zorianna Vern-Gross, DO
• Paula LH Vestin, NCC LPC
• Barbara A Vieiralves, APNP
• Lila (Terri) Vieth, RN
• Morgan Voegeli
• Vop Monroe LLC (Dimensions Living Monroe I)
• Vop Monroe LLC (Dimensions Living Monroe II)
• Stephen P Wagner, M.D.
• David Charles Wake, DDS

• Community/Behavioral Health Agency in Monroe, WI
• Providers in Monroe, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.