Provider Demographics
NPI:1174399729
Name:VITAPLUS HOME CARE LLC
Entity type:Organization
Organization Name:VITAPLUS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIOKENG KENYANTIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-545-7866
Mailing Address - Street 1:3314 BATTLECRY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-4672
Mailing Address - Country:US
Mailing Address - Phone:214-545-7866
Mailing Address - Fax:
Practice Address - Street 1:8122 MARBACH RD STE 121
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1690
Practice Address - Country:US
Practice Address - Phone:210-569-2898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty