Provider Demographics
NPI:1477393965
Name:VESTA STRUCTURE FAMILY CARE
Entity type:Organization
Organization Name:VESTA STRUCTURE FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-509-9720
Mailing Address - Street 1:6329 W PHILADELPHIA DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-6064
Mailing Address - Country:US
Mailing Address - Phone:317-509-9720
Mailing Address - Fax:
Practice Address - Street 1:6329 W PHILADELPHIA DR
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-6064
Practice Address - Country:US
Practice Address - Phone:317-509-9720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
No333300000XSuppliersEmergency Response System Companies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care