Provider Demographics
NPI:1275203382
Name:VLA HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:VLA HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAFAYNE
Authorized Official - Middle Name:PETA-GAYE
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:203-954-6644
Mailing Address - Street 1:129 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2220
Mailing Address - Country:US
Mailing Address - Phone:203-400-8155
Mailing Address - Fax:
Practice Address - Street 1:129 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2220
Practice Address - Country:US
Practice Address - Phone:203-400-8155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health