Vita Health Initiative LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

VITA HEALTH INITIATIVE LLC

Practice address

258 Green Meadows Rd
Wilmer, TX 75172-3335

Phone

(504) 434-8476

NPI assigned

Mar 4, 2021

Last updated

Jul 12, 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

Dr. Mazvita Maziveyi

Title

Owner

Phone

(504) 434-8476

Specialties & licenses 6

Addresses

Tax ID family

Vita Health Initiative LLC2 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.

• Vita Health Initiative, LLC

  • Family Medicine Physician
  • Wilmer, TX
  • NPI 1669108437
  NPD tax ID

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1821683608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 GREEN MEADOWS RD",
            "city": "WILMER",
            "state": "TX",
            "postal_code": "751723335",
            "telephone_number": "504-434-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 GREEN MEADOWS RD",
            "city": "WILMER",
            "state": "TX",
            "postal_code": "751723335",
            "telephone_number": "504-434-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA HEALTH INITIATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "MAZIVEYI",
        "authorized_official_first_name": "MAZVITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-434-8476",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• E'Quecia L Griffin
• Stacy Nicole Johnson
• Tdenise Mack
• Medline Industries, LP
• Robert Cleveland Muncrief III, LPC
• Vita Health Initiative, LLC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wilmer, TX
• Providers in Wilmer, TX by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.