Provider Demographics
NPI:1528253325
Name:VITAL INDIVIDUALS SEEKING INDEPENDENT OPPORTUNITIES NATIONWIDE, INC.
Entity type:Organization
Organization Name:VITAL INDIVIDUALS SEEKING INDEPENDENT OPPORTUNITIES NATIONWIDE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:SINCLAIR
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-937-3870
Mailing Address - Street 1:142A WOODRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2294
Mailing Address - Country:US
Mailing Address - Phone:252-937-3870
Mailing Address - Fax:252-937-3871
Practice Address - Street 1:142A WOODRIDGE CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2294
Practice Address - Country:US
Practice Address - Phone:252-937-3870
Practice Address - Fax:252-937-3871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health