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General NPI Number Information
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NPI Number | 1083348676
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Entity Type | Organization
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Legal Business Name | VITAL HOME HEALTH LLC
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 5345 WYOMING BLVD NE STE 203
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3148
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Country | US
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Telephone | 505-433-4228
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Fax | 505-433-4249
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Provider Business Mailing Address
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Address Line | 3135 MOUNTAINSIDE PKWY NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111
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Country | US
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Telephone | 505-385-2852
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TENZIN YANGCHEN
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Credential | CNP
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Telephone | 505-385-2852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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