Provider Demographics
NPI:1629620745
Name:VIBRANT ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:VIBRANT ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-317-5315
Mailing Address - Street 1:1172 W GALBRAITH RD STE 205B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5644
Mailing Address - Country:US
Mailing Address - Phone:513-954-8576
Mailing Address - Fax:
Practice Address - Street 1:1172 W GALBRAITH RD STE 205B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5644
Practice Address - Country:US
Practice Address - Phone:513-954-8576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care