NPIMap

Organization Active NPI

Vivent Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
National Provider Identifier
1578857967
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
VIVENT HEALTH INC
Practice address
445 S Adams St
Green Bay, WI 54301-4107
Phone
(920) 437-7400
Fax
(920) 437-1040
NPI assigned
Jun 3, 2011
Last updated
May 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tanya Mauldin
Title
Exec VP
Phone
(866) 525-5484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

445 S Adams St
Green Bay, WI 54301-4107

Mailing address

820 N Plankinton Ave
Milwaukee, WI 53203-1802
Phone (414) 225-1542

Other identifiers 1

IdentifierTypeStateIssuer
42228200MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
AIDS Resource Ctr Wi in7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

445 S Adams St
Green Bay, WI 54301
Phone (920) 437-7400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1578857967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N PLANKINTON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031802",
            "telephone_number": "414-225-1542",
            "fax_number": "414-225-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S ADAMS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014107",
            "telephone_number": "920-437-7400",
            "fax_number": "920-437-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVENT HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-03",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "MAULDIN",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "EXEC VP",
        "authorized_official_telephone_number": "866-525-5484",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42228200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.