| Vital Care Home | |
|
1106 E 11 Mile Rd Royal Oak MI 48067-2048 | |
| (917) 373-1886 | |
| Not Available |
| Full Name | Vital Care Home |
|---|---|
| Speciality | Family Medicine |
| Location | 1106 E 11 Mile Rd, Royal Oak, Michigan |
| Authorized Official Name and Position | Marie Elizabeth Mateo (OWNER) |
| Authorized Official Contact | 9173731886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Care Home 1106 E 11 Mile Rd Royal Oak MI 48067-2048 | Vital Care Home 1106 E 11 Mile Rd Royal Oak MI 48067-2048 Ph: (917) 373-1886 |
| NPI Number | 1114731924 |
|---|---|
| Provider Enumeration Date | 02/03/2025 |
| Last Update Date | 05/08/2026 |
| Certification Date | 05/08/2026 |
| Medicare PECOS PAC ID | 7214406552 |
|---|---|
| Medicare Enrollment ID | O20260515003210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114731924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Marie E Mateo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558327023 PECOS PAC ID: 7416933619 Enrollment ID: I20100111000371 |
| Provider Name | James L Tougas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073991477 PECOS PAC ID: 2466768916 Enrollment ID: I20150831000568 |
| Provider Name | Jessica L Mcdiarmid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417493065 PECOS PAC ID: 5597047985 Enrollment ID: I20170119001597 |
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