Provider Demographics
NPI:1487675823
Name:VITA-LIVING, INC.
Entity Type:Organization
Organization Name:VITA-LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSW-AP
Authorized Official - Phone:713-292-1806
Mailing Address - Street 1:3300 S GESSNER RD
Mailing Address - Street 2:SUITE # 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5100
Mailing Address - Country:US
Mailing Address - Phone:713-271-5795
Mailing Address - Fax:713-981-4512
Practice Address - Street 1:3300 S GESSNER RD
Practice Address - Street 2:SUITE # 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5100
Practice Address - Country:US
Practice Address - Phone:713-271-5795
Practice Address - Fax:713-981-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000600500251B00000X
TX001015832251B00000X
TX000385901315P00000X
TX000368401315P00000X
TX000389501315P00000X
TX760037167320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities