Organization
VITALITYHOME HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY AGUILA (DIRECTOR)
(847) 346-9907
Entity
Organization
Contact information
Practice address
4123 FOUNTAINSIDE LN, FAIRFAX, VA 22030-7402
(847) 346-9913
Mailing address
4123 FOUNTAINSIDE LN, FAIRFAX, VA 22030-7402
(847) 346-9913
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/22/2018
Last updated
12/22/2018
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