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General NPI Number Information
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NPI Number | 1306546767
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Entity Type | Organization
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Legal Business Name | VIVIS HOME LLC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 46 INDIAN WELLS DR
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City | MANVEL
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State | TX
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Zip | 77578-3387
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Country | US
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Telephone | 561-358-2625
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Fax |
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Provider Business Mailing Address
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Address Line | 46 INDIAN WELLS DR
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City | MANVEL
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State | TX
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Zip | 77578-3387
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Country | US
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Telephone | 713-340-8010
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Fax | 832-342-9892
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Authorized Official
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Title or Position | OPERATOR
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Name | MS. JESSE MINASSO
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Credential |
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Telephone | 713-340-8010
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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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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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