- Enrollment id
- O20200320000906
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1679842298
- Multiple npi flag
- N
- Ccn
- 459471
- Associate id
- 6002244316
- Organization name
- ALTUS HOME HEALTH, LLC
- Doing business as name
- VITALCARING GROUP
- Incorporation date
- 2019-10-01
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 350 PINE ST
- Address line 2
- STE 327
- City
- BEAUMONT
- State
- TX
- Zip code
- 777012437