Vivid Idea Rehab

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

VIVID IDEA REHAB

Practice address

2101 West Stoker Dr
Saginaw, MI 48604

Phone

(989) 239-2376

NPI assigned

Oct 25, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Dexter A Mitchell Sr.

Title

Ceo

Phone

(989) 239-2376

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982980751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W STOKER DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042441",
            "telephone_number": "989-239-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WEST STOKER DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48604",
            "telephone_number": "989-239-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID IDEA REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-239-2376",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.