| Vitalize Healthcare Ltd. Co. | |
| 386 Waller Ave Ste 103-104 Lexington KY 40504-2917 | |
| (252) 315-5165 | |
| Not Available | 
| Full Name | Vitalize Healthcare Ltd. Co. | 
|---|---|
| Speciality | Community/behavioral Health | 
| Location | 386 Waller Ave Ste 103-104, Lexington, Kentucky | 
| Authorized Official Name and Position | Brandon Eugene Sims (MANAGER) | 
| Authorized Official Contact | 2523155165 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Vitalize Healthcare Ltd. Co. 386 Waller Ave Ste 103-104 Lexington KY 40504-2917 Ph: (252) 315-5165 | Vitalize Healthcare Ltd. Co. 386 Waller Ave Ste 103-104 Lexington KY 40504-2917 Ph: (252) 315-5165 | 
| NPI Number | 1356887616 | 
|---|---|
| Provider Enumeration Date | 01/10/2017 | 
| Last Update Date | 01/10/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1356887616 | NPI | - | NPPES | 
| 1 | Medicaid | KY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Kentucky) | Primary | 
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