Provider Demographics
NPI:1518674837
Name:VIBRANT MIND
Entity Type:Organization
Organization Name:VIBRANT MIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ABBI
Authorized Official - Middle Name:
Authorized Official - Last Name:MANKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC
Authorized Official - Phone:616-259-0985
Mailing Address - Street 1:1037 N MITCHELL ST STE 12
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-1287
Mailing Address - Country:US
Mailing Address - Phone:616-259-0985
Mailing Address - Fax:
Practice Address - Street 1:1037 N MITCHELL ST STE 12
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-1287
Practice Address - Country:US
Practice Address - Phone:616-259-0985
Practice Address - Fax:231-208-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty