Organization
VITALITY HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANGANO J KAGABO (PROGRAM MANAGER)
(317) 602-0991
Entity
Organization
Contact information
Practice address
12890 OLD MERIDIAN ST APT 207, CARMEL, IN 46032-8921
(317) 602-0991
Mailing address
12890 OLD MERIDIAN ST APT 207, CARMEL, IN 46032-8921
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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