Provider Demographics
NPI:1598353633
Name:VITACARE SUPPORT LLC
Entity Type:Organization
Organization Name:VITACARE SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIRICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-396-9237
Mailing Address - Street 1:928 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5109
Mailing Address - Country:US
Mailing Address - Phone:201-396-9237
Mailing Address - Fax:
Practice Address - Street 1:928 HUDSON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5109
Practice Address - Country:US
Practice Address - Phone:201-396-9237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health