Provider Demographics
NPI:1457180424
Name:VITAL LIVING HOME CARE LLC
Entity type:Organization
Organization Name:VITAL LIVING HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCK
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-865-7070
Mailing Address - Street 1:40315 MICHIGAN AVE # 1084
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2908
Mailing Address - Country:US
Mailing Address - Phone:734-865-7070
Mailing Address - Fax:
Practice Address - Street 1:8101 RIVERDALE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1574
Practice Address - Country:US
Practice Address - Phone:734-865-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251S00000XAgenciesCommunity/Behavioral Health