Organization
VIDAL HOME CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASHAN PRUITT (OWNER)
(267) 229-7556
Entity
Organization
Contact information
Practice address
510 N BROAD ST APT 305, PHILADELPHIA, PA 19130-4335
(267) 229-7556
Mailing address
40 ROCKY POOL LN, LEVITTOWN, PA 19055-1128
(267) 229-7556
Taxonomy
Speciality
Code
Description
License number
State
364SH0200X
Home Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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