Provider Demographics
NPI:1902781370
Name:VITAL CARE SUPPORT SERVICES
Entity type:Organization
Organization Name:VITAL CARE SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SEQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE-MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-912-4380
Mailing Address - Street 1:5031 GERHING DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-1772
Mailing Address - Country:US
Mailing Address - Phone:317-640-3292
Mailing Address - Fax:
Practice Address - Street 1:5031 GERHING DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-1772
Practice Address - Country:US
Practice Address - Phone:317-640-3292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care