Provider Demographics
NPI:1205594280
Name:VITAL SERVICES INC.
Entity type:Organization
Organization Name:VITAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QIDO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:HILE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:402-465-5664
Mailing Address - Street 1:6400 CORNHUSKER HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-3123
Mailing Address - Country:US
Mailing Address - Phone:402-465-5664
Mailing Address - Fax:402-465-4065
Practice Address - Street 1:6400 CORNHUSKER HWY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68507-3123
Practice Address - Country:US
Practice Address - Phone:402-465-5664
Practice Address - Fax:402-465-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities