MEDICARE: VIBRANT CARE HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639023963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIBRANT CARE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	5922 BURGOYNE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2902
Country	:	US
Telephone Number	:	832-993-9691
Fax Number	:

Provider Business Practice Location Address
First Line	:	5922 BURGOYNE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2902
Country	:	US
Telephone Number	:	832-993-9691
Fax Number	:

Authorized Official
Title or Position	:	CEO/ OWNER
Name	:	ROBERT GHOLSON JR.
Credential	:
Telephone Number	:	832-993-9691

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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