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General NPI Number Information
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NPI Number | 1740006451
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Entity Type | Organization
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Legal Business Name | VITALCARE HEALTH HOME
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 17567 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5724
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Country | US
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Telephone | 718-424-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 27 LAUREL DR
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City | GREAT NECK
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State | NY
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Zip | 11021-2826
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Country | US
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Telephone | 347-426-7773
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAHID HOSSAIN
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Credential |
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Telephone | 347-426-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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