Provider Demographics
NPI:1437409877
Name:VIVACE HEALTH & WELLNESS, INC
Entity Type:Organization
Organization Name:VIVACE HEALTH & WELLNESS, INC
Other - Org Name:LAVIDA MASSAGE OF SANDY SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMES DE SOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-433-2018
Mailing Address - Street 1:5944 ROSWELL RD NE
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5944 ROSWELL RD NE
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4908
Practice Address - Country:US
Practice Address - Phone:404-236-7291
Practice Address - Fax:678-399-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty