Vibrant Elevation LLC
Organization Active NPI Behavior Technician · Glendale, AZ
NPI 1104527480 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1104527480
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Behavior Technician 106S00000X
- Legal business name
- VIBRANT ELEVATION LLC
- Practice address
- 4480 W Peoria Ave Ste 204
Glendale, AZ 85302-2039 - Phone
- (702) 812-2374
- NPI assigned
- Mar 14, 2023
- Organization subpart
- No
Authorized official
- Name
- Veronica Jean Nicholson
- Title
- Owner
- Phone
- (702) 812-2374
National Provider Directory
Locations
4480 W Peoria Ave
Ste 204
Glendale, AZ 85302
Phone (702) 812-2374
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | Yes |
Addresses
Primary practice location
4480 W Peoria Ave Ste 204
Glendale, AZ 85302-2039
Mailing address
4480 W Peoria Ave Ste 204
Glendale, AZ 85302-2039
Phone (702) 812-2374
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All providers in Glendale, AZ · Behavior Technician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.