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Organization

VITAL SUPPORT SUPPORT COORDINATION AGENCY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. VARELINE VAZQUEZ (CEO)
(215) 379-3300
Entity
Organization

Contact information

Practice address
333 TOWNSHIP LINE RD, SUITE 201, ELKINS PARK, PA 19027-2272
(215) 379-3300
(215) 379-3400
Mailing address
333 TOWNSHIP LINE RD, SUITE 201, ELKINS PARK, PA 19027-2272
(215) 379-3300
(215) 379-3400

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
302R00000X
Health Maintenance Organization

Other

Enumeration date
08/12/2009
Last updated
06/11/2012
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