Vitality Health Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITALITY HEALTH CLINIC

Practice address

4245 S Beech Daly St
Dearborn Heights, MI 48125-1576

Phone

(313) 671-8961

NPI assigned

Feb 28, 2024

Last updated

Feb 28, 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

Mariam Abbas, AGPCNPNPI 1982352811

Title

Nurse Practitioner

Phone

(313) 671-8961

Specialties & licenses 1

Addresses

Tax ID family

Vitality Health Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vitality Health Clinic PLLC

  • Family Medicine Physician
  • Dearborn Heights, MI
  • NPI 1689430407
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mariam Abdul-Hussein Abbas

  • Gerontology Nurse Practitioner
  • Southgate, MI
  • NPI 1982352811
  NPD Authorized official
• Rawya Kazan, AGPCNP

  • Primary Care Nurse Practitioner
  • Westland, MI
  • NPI 1023743432
  NPD

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1760248587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 S BEECH DALY ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251576",
            "telephone_number": "313-671-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 S BEECH DALY ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251576",
            "telephone_number": "313-671-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "ABBAS",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "313-671-8961",
        "authorized_official_credential": "AGPCNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vista Maria
• Vista Maria Good Shepherd
• Vitae Health Medical Michigan PLLC
• Vital Care Agency
• Vital Living Home Care LLC
• Vitality Health Clinic PLLC
• Vivarx LLC
• Vue Eye Boutique PLLC
• William Jesse Wachter, PT
• Hekmat M Wahab, LBA

• Clinic/Center in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.