Provider Demographics
NPI:1235475815
Name:VITA NOVA HEALTHCARE, LLC
Entity Type:Organization
Organization Name:VITA NOVA HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:302-765-8093
Mailing Address - Street 1:448 STELLA DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-1901
Mailing Address - Country:US
Mailing Address - Phone:302-765-8093
Mailing Address - Fax:
Practice Address - Street 1:448 STELLA DR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-1901
Practice Address - Country:US
Practice Address - Phone:302-765-8093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-29
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion