Provider Demographics
NPI:1619045176
Name:VITAL PLUS HOME HEALTH CARE
Entity Type:Organization
Organization Name:VITAL PLUS HOME HEALTH CARE
Other - Org Name:ACCESS TLC HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-517-1620
Mailing Address - Street 1:5401 TECH CIR
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1769
Mailing Address - Country:US
Mailing Address - Phone:818-551-1900
Mailing Address - Fax:818-551-1991
Practice Address - Street 1:1051 N MACLAY AVE
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1347
Practice Address - Country:US
Practice Address - Phone:818-551-1900
Practice Address - Fax:818-551-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 171W00000X, 251E00000X
CA550000243251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No251E00000XAgenciesHome Health