Healthcare Provider Details

I. General information

NPI: 1154759645
Provider Name (Legal Business Name): VIBRUS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23100 PROVIDENCE DR SUITE 227
SOUTHFIELD MI
48075-3646
US

IV. Provider business mailing address

23100 PROVIDENCE DR SUITE 227
SOUTHFIELD MI
48075-3646
US

V. Phone/Fax

Practice location:
  • Phone: 248-443-5100
  • Fax:
Mailing address:
  • Phone: 248-443-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. PADDY NAIDU
Title or Position: PRESIDENT
Credential:
Phone: 248-443-5100