Healthcare Provider Details

I. General information

NPI: 1043865983
Provider Name (Legal Business Name): VIBRANT HEALTHCARE STAFFING & HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 S TACOMA WAY
TACOMA WA
98409-4312
US

IV. Provider business mailing address

5003 59TH AVENUE CT W
UNIVERSITY PLACE WA
98467-4134
US

V. Phone/Fax

Practice location:
  • Phone: 253-240-6489
  • Fax:
Mailing address:
  • Phone: 253-355-3087
  • Fax: 855-413-7319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNET ASIO-PASQUALI
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 253-240-6489