VITAL ROOTS INC NPI 1720663818

NPI Information

NPI: 1720663818
Provider Name: VITAL ROOTS INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
6929 APPLE LN APT 2
CARBONDALE, IL
ZIP 62902
Phone: (833) 337-6687
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VITAL ROOTS INC is a mental health (including community mental health center) clinic center in Carbondale, IL. VITAL ROOTS INC NPI is 1720663818. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6929 APPLE LN APT 2
CARBONDALE, IL
ZIP 62902-302
Phone: (833) 337-6687

The provider's authorized official is Lee Cavender .
The authorized official title is Owner And Counselor and has the following contact phone number (615) 900-0984.

The enumeration date for this NPI number is 3/10/2021 and was last updated on 3/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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