Vita Health Initiative LLC

NPI #1821683608 in Wilmer, Texas

Provider Information

NPI Number: 1821683608
Entity Type: Organization
Organization Name: Vita Health Initiative LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 4, 2021
Last Updated: Jul 12, 2022

Practice Location

Address: 258 GREEN MEADOWS RD
City: Wilmer
State: Texas
ZIP Code: 75172-3335
Phone: (504) 434-8476

Authorized Official

Name: DR. MAZVITA MAZIVEYI
Title: OWNER
Phone: (504) 434-8476

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Health Maintenance Organization	302R00000X
Preferred Provider Organization	305R00000X
Point of Service	305S00000X
Physiological Laboratory	293D00000X
Exclusive Provider Organization	302F00000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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