Provider Demographics
NPI:1003310582
Name:VITALITY CARE, LLC
Entity Type:Organization
Organization Name:VITALITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TETYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:303-993-5033
Mailing Address - Street 1:3000 S JAMAICA CT STE 335
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4603
Mailing Address - Country:US
Mailing Address - Phone:303-993-5033
Mailing Address - Fax:303-945-2404
Practice Address - Street 1:3000 S JAMAICA CT STE 335
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4603
Practice Address - Country:US
Practice Address - Phone:303-993-5033
Practice Address - Fax:303-945-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health