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Organization
VITAL AGENCY LLC
Active
Organization
VITAL AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAMBAGO KALEMA (CEO)
(612) 275-3889
Entity
Organization
Contact information
Practice address
12864 FILLMORE STREET NE, BLAINE, MN 55434
(612) 275-3889
Mailing address
12864 FILLMORE STREET NE, BLAINE, MN 55434
(612) 275-3889
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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