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General NPI Number Information
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NPI Number | 1407048291
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Entity Type | Organization
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Legal Business Name | NC-VITAL HEALTHCARE INC.
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 337 OAKS TRL SUITE 105
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City | GARLAND
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State | TX
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Zip | 75043-4096
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Country | US
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Telephone | 214-484-3163
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Fax | 214-484-3257
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Provider Business Mailing Address
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Address Line | 337 OAKS TRL SUITE 105
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City | GARLAND
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State | TX
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Zip | 75043-4096
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Country | US
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Telephone | 214-484-3163
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Fax | 214-484-3257
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. VIVIAN ELEGONYE
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Credential | RN
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Telephone | 214-437-9530
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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 | 011866
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License Number State | TX
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