- Enrollment id
- O20230705000489
- Enrollment state
- NV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1710691449
- Multiple npi flag
- N
- Ccn
- 297371
- Associate id
- 4789043043
- Organization name
- VITAL CARE HOME HEALTH INC
- Incorporation date
- 2022-12-14
- Incorporation state
- NV
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3750 S JONES BLVD
- Address line 2
- STE 140
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891032209