Healthcare Provider Details

I. General information

NPI: 1528050846
Provider Name (Legal Business Name): VITAL HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E FOOTHILL BLVD STE. 501
PASADENA CA
91107-3464
US

IV. Provider business mailing address

2500 E FOOTHILL BLVD STE. 501
PASADENA CA
91107-3464
US

V. Phone/Fax

Practice location:
  • Phone: 626-432-6650
  • Fax: 626-432-6653
Mailing address:
  • Phone: 626-432-6650
  • Fax: 626-432-6653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ELSA V. LIM
Title or Position: CEO/ ADMINISTRATOR
Credential: RN
Phone: 626-432-6650