Provider Demographics
NPI:1689555179
Name:VITAL MENTAL HEALTH
Entity type:Organization
Organization Name:VITAL MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:VITAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:563-940-7687
Mailing Address - Street 1:9138 GALE BLVD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-4994
Mailing Address - Country:US
Mailing Address - Phone:720-593-9856
Mailing Address - Fax:
Practice Address - Street 1:9138 GALE BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-4994
Practice Address - Country:US
Practice Address - Phone:720-593-9856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health