VIDA WELLNESS NPI 1073246047

NPI Information

  • NPI: 1073246047
  • Provider Name: VIDA WELLNESS
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Address: 3167 KALAMAZOO AVE SE STE 205
    GRAND RAPIDS, MI
    ZIP 49508
  • Phone: (773) 987-1357

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NPI Details

VIDA WELLNESS is a multi-specialty clinic center in Grand Rapids, MI. VIDA WELLNESS NPI is 1073246047. The provider is registered as an organization entity type.

The provider's business location address is:

3167 KALAMAZOO AVE SE STE 205
GRAND RAPIDS, MI
ZIP 49508-475
Phone: (773) 987-1357
Fax: (616) 414-8530

The provider's authorized official is Rebeca E Davila .
The authorized official title is Owner and has the following contact phone number (773) 987-1357.

The enumeration date for this NPI number is 7/6/2022 and was last updated on 7/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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