Vidi Revive LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

VIDI REVIVE LLC

Practice address

6895 E Camelback Rd Unit 1024
Scottsdale, AZ 85251-2475

Phone

(917) 545-1840

NPI assigned

May 15, 2020

Last updated

May 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Salaih Radney

Title

Owner

Phone

(917) 545-1840

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1831711514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6895 E CAMELBACK RD UNIT 1024",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6895 E CAMELBACK RD UNIT 1024",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512475",
            "telephone_number": "917-545-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDI REVIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "RADNEY",
        "authorized_official_first_name": "SALAIH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-545-1840"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Rose Vickers, PA-C
• Nancy Vickerson
• Hope Ryan Vickery, RD
• Victor Vincent Vickrey, ACMHC
• Jay Victor, M.D.
• Viewpoint Scottsdale Recovery Center, LLC
• Robert W Viggiano, M.D.
• Taylor Alexandra Viggiano, MD
• Diana G. Vigil, M.A., R.P.T. LPC
• Krishnaswami Vijayaraghavan, M.D.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.