Vibrance Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

VIBRANCE HOME CARE LLC

Practice address

1066 County Highway 10 Unit 405
Spring Lake Park, MN 55432-2668

Phone

(612) 512-1004

NPI assigned

Jul 31, 2023

Organization subpart

No

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

Authorized official

Name

Riyak Abdi Omar

Title

Ceo

Phone

(612) 512-1004

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1912688912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 COUNTY HIGHWAY 10 UNIT 405",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322668",
            "telephone_number": "612-512-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 COUNTY HIGHWAY 10 UNIT 405",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322668",
            "telephone_number": "612-512-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANCE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "RIYAK",
        "authorized_official_middle_name": "ABDI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-512-1004"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Spring Lake Park, MN
• Providers in Spring Lake Park, MN by specialty
• In Home Supportive Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.