Provider Demographics
NPI:1639637200
Name:VITA HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:VITA HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LILIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSEGHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-290-2098
Mailing Address - Street 1:24404 VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2313
Mailing Address - Country:US
Mailing Address - Phone:310-290-2098
Mailing Address - Fax:
Practice Address - Street 1:24404 VERMONT AVE STE 309
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2324
Practice Address - Country:US
Practice Address - Phone:310-290-2098
Practice Address - Fax:323-238-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-03
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid