| NPI | 1205456001 |
|---|---|
| Former Legal Business Name | VITALITY MGM LLC |
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA STABILE Controller 702-240-8531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |