Provider Demographics
NPI:1083180012
Name:VITALCARE CORPORATION
Entity Type:Organization
Organization Name:VITALCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-458-0643
Mailing Address - Street 1:1400 W 122ND AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3440
Mailing Address - Country:US
Mailing Address - Phone:720-458-0642
Mailing Address - Fax:720-815-3372
Practice Address - Street 1:1400 W 122ND AVE STE 140
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3440
Practice Address - Country:US
Practice Address - Phone:720-458-0642
Practice Address - Fax:720-815-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty