Provider Demographics
NPI:1629506902
Name:VIBRANT LIVING SERVICES LLC
Entity Type:Organization
Organization Name:VIBRANT LIVING SERVICES LLC
Other - Org Name:PAM HEALTH AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-808-0001
Mailing Address - Street 1:9025 E KENYON AVE STE 50
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1980
Mailing Address - Country:US
Mailing Address - Phone:720-808-0001
Mailing Address - Fax:720-505-2123
Practice Address - Street 1:9025 E KENYON AVE STE 50
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1980
Practice Address - Country:US
Practice Address - Phone:720-808-0001
Practice Address - Fax:720-505-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health