Vitality Healthcare LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

VITALITY HEALTHCARE LLC

Practice address

12890 Old Meridian St Apt 207
Carmel, IN 46032-8921

Phone

(317) 602-0991

NPI assigned

Dec 18, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sangano J Kagabo

Title

Program Manager

Phone

(317) 602-0991

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1598533853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12890 OLD MERIDIAN ST APT 207",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12890 OLD MERIDIAN ST APT 207",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328921",
            "telephone_number": "317-602-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "KAGABO",
        "authorized_official_first_name": "SANGANO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "317-602-0991"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Carmel, IN
• Providers in Carmel, IN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.