Provider Demographics
NPI:1548086853
Name:VITALITY HOME CARE, LLC
Entity type:Organization
Organization Name:VITALITY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-220-3781
Mailing Address - Street 1:1900 SE 34TH AVE, STE 1500 #533 AMARILLO, TX 79118
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118
Mailing Address - Country:US
Mailing Address - Phone:806-220-3781
Mailing Address - Fax:
Practice Address - Street 1:14800 TWIN LAKES RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79118-4629
Practice Address - Country:US
Practice Address - Phone:806-220-3781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health