Provider Demographics
NPI:1033927579
Name:SANA VITA, PLLC
Entity type:Organization
Organization Name:SANA VITA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER/OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-447-8253
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-1053
Mailing Address - Country:US
Mailing Address - Phone:828-447-8253
Mailing Address - Fax:828-537-1373
Practice Address - Street 1:185 N MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2501
Practice Address - Country:US
Practice Address - Phone:828-447-8253
Practice Address - Fax:828-537-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health