Provider Demographics
NPI:1073736757
Name:VIP HOME CARE LLC
Entity Type:Organization
Organization Name:VIP HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-847-0171
Mailing Address - Street 1:25920 IRIS AVE
Mailing Address - Street 2:STE 13A-267
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-1658
Mailing Address - Country:US
Mailing Address - Phone:888-847-0171
Mailing Address - Fax:
Practice Address - Street 1:25920 IRIS AVE
Practice Address - Street 2:STE 13A-267
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92551-1658
Practice Address - Country:US
Practice Address - Phone:888-847-0171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200633310002251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health