Provider Demographics
NPI:1467937243
Name:VITAL WELLNESS HOME HEALTH INC.
Entity Type:Organization
Organization Name:VITAL WELLNESS HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NELIA
Authorized Official - Middle Name:LAUREL-
Authorized Official - Last Name:LADLAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-332-9568
Mailing Address - Street 1:1717 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3735
Mailing Address - Country:US
Mailing Address - Phone:177-333-9568
Mailing Address - Fax:773-345-4637
Practice Address - Street 1:2681 MONTEGA DR.
Practice Address - Street 2:SUITE E
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:60704
Practice Address - Country:US
Practice Address - Phone:217-717-1909
Practice Address - Fax:217-717-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care