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General NPI Number Information
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NPI Number | 1669726196
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Entity Type | Organization
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Legal Business Name | VITALIS HOME HEALTH LLC
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 9550 FOREST LN STE 309
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City | DALLAS
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State | TX
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Zip | 75243-6060
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Country | US
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Telephone | 202-390-6884
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Fax | 972-476-0870
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Provider Business Mailing Address
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Address Line | 9550 FOREST LN STE 309
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City | DALLAS
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State | TX
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Zip | 75243-6060
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Country | US
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Telephone | 202-390-6884
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Fax | 972-476-0870
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Authorized Official
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Title or Position | PRESIDENT/ADMIN
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Name | MR. DESMOND O ARREY
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Credential |
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Telephone | 202-390-6884
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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 | 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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