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General NPI Number Information
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NPI Number | 1154266344
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Entity Type | Organization
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Legal Business Name | VITA STAR HOME HEALTHCARE INC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 12362 BEACH BLVD STE 24
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City | STANTON
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State | CA
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Zip | 90680-3961
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Country | US
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Telephone | 844-840-5517
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Fax | 714-441-5364
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Provider Business Mailing Address
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Address Line | 12362 BEACH BLVD STE 24
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City | STANTON
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State | CA
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Zip | 90680-3961
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Country | US
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Telephone | 844-840-5517
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Fax | 714-441-5364
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PAUL KIM
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Credential | LNHA
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Telephone | 844-840-5517
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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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