Provider Demographics
NPI:1477277051
Name:VITALITY MOBILE NURSING SERVICES LLC
Entity Type:Organization
Organization Name:VITALITY MOBILE NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE HALL
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-249-6381
Mailing Address - Street 1:11740 SW VILLAGE PKWY APT 307
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2598
Mailing Address - Country:US
Mailing Address - Phone:772-249-6381
Mailing Address - Fax:
Practice Address - Street 1:11740 SW VILLAGE PKWY APT 307
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2598
Practice Address - Country:US
Practice Address - Phone:772-249-6381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care