Vici Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

VICI HEALTH, LLC

Practice address

282 SW Mt St Helens St
McMinnville, OR 97128-5590

Phone

(650) 285-7209

NPI assigned

Nov 25, 2019

Organization subpart

No

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

Authorized official

Name

Duston Sackett

Title

Founder, Ceo

Phone

(650) 285-7209

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1972149938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 SW MT ST HELENS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971285590",
            "telephone_number": "650-285-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 SW MT ST HELENS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971285590",
            "telephone_number": "650-285-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICI HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "SACKETT",
        "authorized_official_first_name": "DUSTON",
        "authorized_official_title_or_position": "FOUNDER, CEO",
        "authorized_official_telephone_number": "650-285-7209"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamera Vasili
• Teresa Marie Vega
• Alejandra Vera-Oronia
• Michael Brent Vessely, MD
• Irene P Vetto, ANP
• Steven Britton Vierboom, DC
• Karmen Vilander, AGNP
• Joel Viles, PA-C
• Ingrid Marika Viljak, DDS
• Jessica Lachman Vincent, PAC

• Community/Behavioral Health Agency in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.