Provider Demographics
NPI:1609462662
Name:VERTEX HOME CARE LLC
Entity Type:Organization
Organization Name:VERTEX HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIRAMBONA
Authorized Official - Suffix:
Authorized Official - Credentials:DSP
Authorized Official - Phone:207-518-1441
Mailing Address - Street 1:246 AUBURN ST APT 153
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2166
Mailing Address - Country:US
Mailing Address - Phone:207-518-1441
Mailing Address - Fax:
Practice Address - Street 1:246 AUBURN ST APT 153
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2166
Practice Address - Country:US
Practice Address - Phone:207-518-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities