Provider Demographics
NPI:1104181429
Name:ALL VITAL HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ALL VITAL HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ASIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:FAROOQI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-836-2013
Mailing Address - Street 1:8840 CALUMET AVE
Mailing Address - Street 2:102B RM 1
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2545
Mailing Address - Country:US
Mailing Address - Phone:219-836-2013
Mailing Address - Fax:219-836-2456
Practice Address - Street 1:8840 CALUMET AVE
Practice Address - Street 2:102B RM 1
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2545
Practice Address - Country:US
Practice Address - Phone:219-836-2013
Practice Address - Fax:219-836-2456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health