Provider Demographics
NPI:1033478946
Name:VERTEX- LIFE
Entity Type:Organization
Organization Name:VERTEX- LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BABASSIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-305-5996
Mailing Address - Street 1:635 PARK MEADOW RD STE 207
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2877
Mailing Address - Country:US
Mailing Address - Phone:240-305-5996
Mailing Address - Fax:
Practice Address - Street 1:635 PARK MEADOW RD STE. 207
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:240-305-5996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health