Healthcare Provider Details
I. General information
NPI: 1871130674
Provider Name (Legal Business Name): VITALS HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2019
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1920 ROSELLE CT
ARLINGTON TX
76018-2590
US
IV. Provider business mailing address
1920 ROSELLE CT
ARLINGTON TX
76018-2590
US
V. Phone/Fax
- Phone: 817-691-5630
- Fax:
- Phone: 817-691-5630
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372600000X |
| Taxonomy | Adult Companion |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUNIRAT
OMOTOLA
BALOGUN
Title or Position: ADMINISTRATOR
Credential: MHA
Phone: 817-691-5630