Provider Demographics
NPI:1023773256
Name:VITA HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:VITA HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-864-1222
Mailing Address - Street 1:2139 TAPO ST STE 214
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3476
Mailing Address - Country:US
Mailing Address - Phone:805-424-1010
Mailing Address - Fax:805-424-5832
Practice Address - Street 1:2139 TAPO ST STE 214
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3476
Practice Address - Country:US
Practice Address - Phone:805-424-1010
Practice Address - Fax:805-424-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health