Vital Health and Wellness Clinic

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

VITAL HEALTH AND WELLNESS CLINIC

Practice address

5540 W Glendale Ave Ste A103
Glendale, AZ 85301-2579

Phone

(602) 825-1613

NPI assigned

Mar 22, 2022

Last updated

Dec 13, 2022By 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

Theophilus Akoh

Title

Owner

Phone

(775) 335-7450

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1750030185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 W GLENDALE AVE STE A103",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 W GLENDALE AVE STE A103",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012579",
            "telephone_number": "602-825-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL HEALTH AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "AKOH",
        "authorized_official_first_name": "THEOPHILUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-335-7450"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "OTC12109",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vineyard Community Charities (Vineyard Medical Clinic)
• Thomas Barnes Virden III, PH.D.
• Mika Visentin, SLPA
• Visionworks Inc (Visionworks)
• Visionworks, Inc, (Visionworks)
• Vital Hospice Care, Inc.
• Vitality Internal Medicine - Glendale LLC (Mens Vitality Center)
• Vitality Performance and Physical Therapy
• Pamela Vitalo, PHARMD
• Vitamin Hope Counseling LLC (vitamin hope counseling)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.