Organization Active NPI

Vibrant Living Services LLC

  • Home Health Agency
  • Denver, CO
National Provider Identifier
1629506902
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Feb 4, 2025

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 HomeCCN 067629
Overall star rating
3 of 5
Ownership
-
Certified
Jun 12, 2023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2134344Vibrant Living Services9025 E Kenyon Ave, #50, Denver, CO 80237Certificate of waiverJul 30, 2027

National Provider Directory

National Provider Directory

Member 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.

NameRoleSinceShare
Anthony F Misitano Individual 5% Or Greater Indirect Ownership Interest Sep 15, 2021 50%
Be Healthy at Home Organization, Buda, TX LLC, For-profit 5% Or Greater Direct Ownership Interest Sep 15, 2021 100%
Brandis Wilmore Individual 5% Or Greater Indirect Ownership Interest Sep 15, 2021 50%
Corporate OfficerPresident/Ceo Sep 15, 2021
W-2 Managing EmployeePresident/Ceo Sep 15, 2021
Operational/Managerial ControlPresident/Ceo 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.

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

Verify at the official NPI Registry.