Healthcare Provider Details

I. General information

NPI: 1447135629
Provider Name (Legal Business Name): VITALCARE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 S LYNHURST DR STE B105D
INDIANAPOLIS IN
46241-8622
US

IV. Provider business mailing address

2346 S LYNHURST DR STE B105D
INDIANAPOLIS IN
46241-8622
US

V. Phone/Fax

Practice location:
  • Phone: 317-662-0028
  • Fax:
Mailing address:
  • Phone: 317-662-0028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SEQUITA ROSE-MASSEY
Title or Position: CO OWNER
Credential: RN
Phone: 317-662-0028