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Contact Information

VITAL SOURCE MINISTRY ENTERPRISE
1401 W FORT ST UNIT 441846
DETROIT, MI48244-3575
 Phone: 313-492-9437
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
 

Private Vehicle

347C00000X
 

Voluntary or Charitable

251V00000X 61 Voluntary Health or Charitable Agency[1]
Indicates primary specialty

NPI Profile & details for VITAL SOURCE MINISTRY ENTERPRISE

NPI # 1235950361
LBN Legal business name VITAL SOURCE MINISTRY ENTERPRISE
Authorized official DAMITA JOHNSON - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/21/2024
Last updated 10/28/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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