Provider Demographics
NPI:1629396957
Name:VITALITY HOME CARE INC.
Entity Type:Organization
Organization Name:VITALITY HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:MOREY
Authorized Official - Last Name:FORDONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-957-9045
Mailing Address - Street 1:24123 GREENFIELD RD STE 211
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3140
Mailing Address - Country:US
Mailing Address - Phone:248-957-9045
Mailing Address - Fax:248-957-9550
Practice Address - Street 1:24123 GREENFIELD RD STE 211
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3140
Practice Address - Country:US
Practice Address - Phone:248-957-9045
Practice Address - Fax:248-957-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health