Provider Demographics
NPI:1316229479
Name:VITA, LLC
Entity Type:Organization
Organization Name:VITA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANZHELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-322-6696
Mailing Address - Street 1:13990 OLIVE BLVD STE 203-2
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2639
Mailing Address - Country:US
Mailing Address - Phone:314-275-4020
Mailing Address - Fax:314-275-4020
Practice Address - Street 1:13990 OLIVE BLVD STE 203-2
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2639
Practice Address - Country:US
Practice Address - Phone:314-275-4020
Practice Address - Fax:314-275-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health