Provider Demographics
NPI:1235323122
Name:VIP LIVING CENTERS LLC
Entity Type:Organization
Organization Name:VIP LIVING CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-254-4477
Mailing Address - Street 1:121 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7413
Mailing Address - Country:US
Mailing Address - Phone:972-254-4477
Mailing Address - Fax:866-217-4336
Practice Address - Street 1:3219 VINSON CT
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-2279
Practice Address - Country:US
Practice Address - Phone:972-513-0224
Practice Address - Fax:866-217-4336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112745310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility