Provider Demographics
NPI:1205339603
Name:VK HEALTHCARE, INC.
Entity type:Organization
Organization Name:VK HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-987-5002
Mailing Address - Street 1:1651 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5206
Mailing Address - Country:US
Mailing Address - Phone:619-202-7258
Mailing Address - Fax:
Practice Address - Street 1:1651 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5206
Practice Address - Country:US
Practice Address - Phone:619-202-7258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374700206251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA374700206OtherHOME CARE SERVICES