Provider Demographics
NPI:1114588308
Name:VITAL HOME HEALTH LLC
Entity Type:Organization
Organization Name:VITAL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:248-905-5056
Mailing Address - Street 1:24001 SOUTHFIELD RD STE 203C
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2847
Mailing Address - Country:US
Mailing Address - Phone:248-905-5056
Mailing Address - Fax:248-905-5058
Practice Address - Street 1:24001 SOUTHFIELD RD STE 203C
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2847
Practice Address - Country:US
Practice Address - Phone:248-905-5056
Practice Address - Fax:248-905-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health