| Organization Name: | CIELO VITALITY HEALTH & WELLNESS CENTER LLC |
| NPI Number: | 1649672106 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONAVON HUFF (VP. OF OPERATIONS) |
| Mailing Address: | 36336 Vine St Suite 100 Willowick |
| State: | OH US |
| Postal Code: | 440953164 |
| Phone Number: | 2162616398 |
| Fax Number: | 2162616398 |
| NPI Enumeration Date: | 09/16/2014 |
| NPI Last Update Date: | 10/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |