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General NPI Number Information
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NPI Number | 1013441542
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Entity Type | Organization
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Legal Business Name | VIBRANT HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 4900 N SCOTTSDALE RD STE 2400
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7652
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Country | US
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Telephone | 480-320-3004
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Fax | 480-383-6540
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Provider Business Mailing Address
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Address Line | 4900 N SCOTTSDALE RD STE 2400
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7652
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Country | US
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Telephone | 480-383-3882
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARETTE ZECHARIA
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Credential | PHD
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Telephone | 480-874-5806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3554
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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