Provider Demographics
NPI:1831929942
Name:TRUVITAL LLC
Entity type:Organization
Organization Name:TRUVITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBYSHENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-410-6888
Mailing Address - Street 1:7725 GATEWAY UNIT 3377
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-5852
Mailing Address - Country:US
Mailing Address - Phone:424-410-6888
Mailing Address - Fax:
Practice Address - Street 1:7725 GATEWAY UNIT 3377
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-5852
Practice Address - Country:US
Practice Address - Phone:424-410-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health