Provider Demographics
NPI:1699292979
Name:VITAE SERVICES OF THE PALM BEACHES, INC.
Entity type:Organization
Organization Name:VITAE SERVICES OF THE PALM BEACHES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:IIAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-732-4559
Mailing Address - Street 1:517 INDUSTRAIL AVE.
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426
Mailing Address - Country:US
Mailing Address - Phone:561-732-4559
Mailing Address - Fax:561-732-6443
Practice Address - Street 1:517 INDUSTRAIL AVE.
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426
Practice Address - Country:US
Practice Address - Phone:561-732-4559
Practice Address - Fax:561-732-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991082251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299991082OtherHOME HEALTH AGENCY