Provider Demographics
NPI:1457887929
Name:VIBRANT, LLC
Entity Type:Organization
Organization Name:VIBRANT, LLC
Other - Org Name:VIBRANT HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-423-9752
Mailing Address - Street 1:3006 E TITUS AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50320-3002
Mailing Address - Country:US
Mailing Address - Phone:515-423-9752
Mailing Address - Fax:
Practice Address - Street 1:3006 E TITUS AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50320-3002
Practice Address - Country:US
Practice Address - Phone:515-423-9752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care