Active NPI
Vibrant Living Services LLC
- Home Health Agency
- Denver, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- VIBRANT LIVING SERVICES LLC
- Practice address
- 9025 E Kenyon Ave Ste 100
Denver, CO 80237-1981 - Phone
- (720) 808-0001
- Fax
- (720) 505-2123
- NPI assigned
- May 31, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brandis Wilmore
- Title
- Owner
- Phone
- (720) 808-0001
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
9025 E Kenyon Ave Ste 100
Denver, CO 80237-1981
Mailing address
9025 E Kenyon Ave Ste 50
Denver, CO 80237-1980
Phone (720) 808-0001
Other names 1
- PAM Health at Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220906002901 | CO | Part A Provider - Home Health Agency | 8224306725 | Practice locations: Denver, CO |
Home health agency certification: CCN 067629
- Legal name
- VIBRANT LIVING SERVICES LLC
- Doing business as
- PAM HEALTH AT HOME
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 12, 2023
- Last certification
- May 26, 2023
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Feb 10, 2017 in CO
- Enrollment address
- 9025 E Kenyon Ave
Ste 100
Denver, CO 80237-1981
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Pam Health at Home
- Overall star rating
- Ownership
- -
- Certified
- Jun 12, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2134344 | Vibrant Living Services | Certificate of waiver | Jul 30, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
9025 E Kenyon Ave
Ste 50
Denver, CO 80237
Phone (720) 808-0001
9025 E Kenyon Ave
Ste 100
Denver, CO 80237
Phone (720) 808-0001
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Anthony F Misitano | 5% Or Greater Indirect Ownership Interest | Sep 15, 2021 | 50% |
| Be Healthy at Home | 5% Or Greater Direct Ownership Interest | Sep 15, 2021 | 100% |
| Brandis Wilmore | 5% Or Greater Indirect Ownership Interest | Sep 15, 2021 | 50% |
| Corporate Officer | Sep 15, 2021 | ||
| W-2 Managing Employee | Sep 15, 2021 | ||
| Operational/Managerial Control | Sep 15, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Home Health Agency
- Buda, TX
- NPI 1548439565
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738627200000",
"number": "1629506902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9025 E KENYON AVE STE 50",
"city": "DENVER",
"state": "CO",
"postal_code": "802371980",
"telephone_number": "720-808-0001",
"fax_number": "720-505-2123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9025 E KENYON AVE STE 100",
"city": "DENVER",
"state": "CO",
"postal_code": "802371981",
"telephone_number": "720-808-0001",
"fax_number": "720-505-2123"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIBRANT LIVING SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-31",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A",
"authorized_official_last_name": "WILMORE",
"authorized_official_first_name": "BRANDIS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "720-808-0001"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PAM Health at Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.