Provider Demographics
NPI:1225417231
Name:VITACARE HOME CARE, LLC
Entity Type:Organization
Organization Name:VITACARE HOME CARE, LLC
Other - Org Name:HOME HELPERS AND DIRECT LINK 58803
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-495-8560
Mailing Address - Street 1:PO BOX 23791
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33623-3791
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3639 CORTEZ RD W
Practice Address - Street 2:SUITE 111
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3103
Practice Address - Country:US
Practice Address - Phone:941-999-1960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health