VITALITY YOUTH SERVICES, LLC (NPI# 1346863180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346863180 |
| Entity Type | Organization |
| Organization Name | VITALITY YOUTH SERVICES, LLC |
| Practice Address |
726 12th Ave Monroe WI 53566-1435 |
| Practice Telephone | 6082930014 |
| Mailing Telephone | 6082930014 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |
| Authorized Official Name | ASHLEE RAE GLOWACKI (OWNER) |
| Authorized Official Telephone | 6082930014 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
726 12TH AVE |
| City | MONROE |
| State | WI |
| Zip Code | 53566-1435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548752967 | Mariah Mohns | Occupational Therapy Assistant | N3150 Wi- 81, Monroe, WI 53566 | 2018-06-01 |
| 1811414907 | Yelena Gapchenko | Pharmacist | 515 22nd St., Monroe, WY 53566 | 2017-08-29 |
| 1508306283 | Hilary Domke | Occupational Therapist | N3150 Wi-81, Monroe, WI 53566 | 2017-03-01 |
| 1699132332 | Lisa Marty | Social Worker | N3152 Wi-81, Monroe, WI 53566 | 2016-01-26 |
| 1518223148 | Lauren Nibler Craddock | Dermatology | 412 18th Ave, Monroe, WI 53566 | 2012-04-09 |
| 1033482799 | Amber Gatdula | Physical Therapy Assistant | 2628 14th Street, Monroe, WI 53566 | 2012-02-10 |
| 1629361043 | Tammy Noble | Licensed Practical Nurse | N2546 Ullom Rd., Monroe, WI 53566 | 2011-05-18 |
| 1023331683 | Kristine Hudson | Registered Nurse | 1110 11th Street, Monroe, WI 53566 | 2010-03-10 |
| 1306005012 | Rosemary Ann Graham | Registered Nurse | 2413 5th Ave, Monroe, WI 53566 | 2008-06-06 |
| 1174702559 | Kelly Jo Jenson | Chiropractor | 1518 11th Street, Suite 1-2, Monroe, WI 53566 | 2007-11-01 |
| Find all providers in zip 53566 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585122 | Cf Counseling & Consulting, LLC | Community/Behavioral Health | 1500 N 19th St, Monroe, LA 71201-4942 | 2020-07-21 |
| 1700347598 | Aspirewell, LLC | Community/Behavioral Health | 1615 Jackson St, Monroe, LA 71202-2029 | 2019-03-26 |
| 1780160390 | Special Care Services of Louisiana Inc | Community/Behavioral Health | 1401 Hudson Ln Ste 135, Monroe, LA 71201-6037 | 2018-07-17 |
| 1760976062 | Kinena J Dent-smith | Community/Behavioral Health | 207 Raymond St, Monroe, NC 28112 | 2018-06-20 |
| 1740789312 | Merakey Pennsylvania | Community/Behavioral Health | 1808 Glenmar Ave, Monroe, LA 71201-4932 | 2018-02-08 |
| 1427563550 | Oak Tree Therapy Pllc | Community/Behavioral Health | 755 Main Street, Building #1, Monroe, CT 06468 | 2017-12-12 |
| 1972016004 | Straight N Arrow Counseling Service, LLC | Community/Behavioral Health | 111 E 1st St Ste 300, Monroe, MI 48161-2265 | 2017-11-11 |
| 1346761822 | Inreach | Community/Behavioral Health | 100 Winchester Ave, Monroe, NC 28110-3161 | 2017-07-05 |
| 1124552088 | The Bridge of Georgia School, Inc | Community/Behavioral Health | 109 Blaine St, Monroe, GA 30655-2403 | 2017-04-18 |
| 1831630326 | New Direction Peer Recovery Center | Community/Behavioral Health | 201 W Front St, Monroe, MI 48161-2355 | 2017-03-16 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.