Healthcare Provider Details

I. General information

NPI: 1659224772
Provider Name (Legal Business Name): VP MOBILE HAIRCUT SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 RIO GRANDE AVE
CARBONDALE CO
81623-1704
US

IV. Provider business mailing address

0098 132 COUNTY RD
GLENWOOD SPRINGS CO
81601
US

V. Phone/Fax

Practice location:
  • Phone: 970-618-4106
  • Fax:
Mailing address:
  • Phone: 970-618-4106
  • Fax: 970-618-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. VANESSA JANETT PORTILLO
Title or Position: OWNER
Credential:
Phone: 970-618-4106