Provider Demographics
NPI: | 1144868100 |
---|---|
Name: | VIVE CARE |
Entity type: | Organization |
Organization Name: | VIVE CARE |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CO-FOUNDER/EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JUSTIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DAY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PMHNP-BC |
Authorized Official - Phone: | 435-703-6470 |
Mailing Address - Street 1: | 120 W 1470 S STE A |
Mailing Address - Street 2: | |
Mailing Address - City: | SAINT GEORGE |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84770-6798 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 435-703-6470 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 120 W 1470 S |
Practice Address - Street 2: | |
Practice Address - City: | SAINT GEORGE |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84770-7581 |
Practice Address - Country: | US |
Practice Address - Phone: | 435-922-0640 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-12-20 |
Last Update Date: | 2021-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 283Q00000X | Hospitals | Psychiatric Hospital | |
No | 273R00000X | Hospital Units | Psychiatric Unit | |
No | 273Y00000X | Hospital Units | Rehabilitation Unit | |
No | 276400000X | Hospital Units | Rehabilitation, Substance Use Disorder Unit | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
No | 283X00000X | Hospitals | Rehabilitation Hospital | |
No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | |
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | |
No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |