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General NPI Number Information
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NPI Number | 1629396957
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Entity Type | Organization
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Legal Business Name | VITALITY HOME CARE INC.
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 24123 GREENFIELD RD STE 211
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3140
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Country | US
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Telephone | 248-957-9045
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Fax | 248-957-9550
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Provider Business Mailing Address
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Address Line | 24123 GREENFIELD RD STE 211
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3140
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Country | US
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Telephone | 248-957-9045
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Fax | 248-957-9550
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SIDNEY MOREY FORDONSKI
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Credential |
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Telephone | 248-957-9045
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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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