Vitality 360 of Baltimore at Providence

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

VITALITY 360 OF BALTIMORE AT PROVIDENCE

Practice address

1427 Pennsylvania Ave
Baltimore, MD 21217-3135

Phone

(443) 606-6424

NPI assigned

Jun 12, 2023

Organization subpart

No

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

Authorized official

Name

Chimere Becote

Title

Founder

Phone

(443) 606-6424

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1912681883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 SEVEN MILE LN",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 PENNSYLVANIA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212173135",
            "telephone_number": "443-606-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY 360 OF BALTIMORE AT PROVIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "BECOTE",
        "authorized_official_first_name": "CHIMERE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "443-606-6424"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Cure Primary Services LLC
• Vital Transit LLC
• Jessica Lauren Vitale, MD
• Vitality 360 Health Care LLC
• Vitality 360 Inc
• Vitality Home Healthcare Associates, LLC
• Vitality NP Group
• Vitality Psychotherapy Services LLC
• Teresa Carol Vitek, OTR/L
• Rukmalee Erandika Vithana

• Adult Day Care Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Adult Day Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.