Healthcare Provider Details

I. General information

NPI: 1639637200
Provider Name (Legal Business Name): VITA HOME HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2019
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24404 VERMONT AVE STE 309
HARBOR CITY CA
90710-2324
US

IV. Provider business mailing address

24404 VERMONT AVE
HARBOR CITY CA
90710-2313
US

V. Phone/Fax

Practice location:
  • Phone: 310-290-2098
  • Fax: 323-238-4864
Mailing address:
  • Phone: 310-290-2098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LILIT BARSEGHYAN
Title or Position: CEO
Credential:
Phone: 310-290-2098