# VITALHEALTH HOME CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902770647
- **Authorized official:** AVA DACANAY RN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (619) 788-9281

## Contact information

- **Practice address:** 9655 GRANITE RIDGE DR STE 201, SAN DIEGO, CA 92123-2676
- **Practice address phone:** (858) 900-7774
- **Mailing address:** 9655 GRANITE RIDGE DR STE 200, SAN DIEGO, CA 92123-2676
- **Mailing address phone:** (858) 900-7774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/04/2025
- **Last updated:** 10/04/2025