Provider Demographics
NPI:1932596954
Name:VIDA HEALTH, INC.
Entity type:Organization
Organization Name:VIDA HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TILENIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-203-7959
Mailing Address - Street 1:26 OFARRELL ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-5809
Mailing Address - Country:US
Mailing Address - Phone:408-203-7959
Mailing Address - Fax:
Practice Address - Street 1:26 OFARRELL ST
Practice Address - Street 2:SUITE 310
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-5809
Practice Address - Country:US
Practice Address - Phone:408-203-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management