Provider Demographics
NPI:1710539838
Name:VITALITY HOME HEALTH, INC .
Entity Type:Organization
Organization Name:VITALITY HOME HEALTH, INC .
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MIRLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CODIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-332-9792
Mailing Address - Street 1:2207 SHIMMERY LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6002
Mailing Address - Country:US
Mailing Address - Phone:561-332-9792
Mailing Address - Fax:561-227-9584
Practice Address - Street 1:7130 S MILITARY TRL STE 1
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7812
Practice Address - Country:US
Practice Address - Phone:561-227-9583
Practice Address - Fax:561-227-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health