# VIDA-FLO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578098471
- **Authorized official:** DR. STEVEN KANE M.D. (SUPERVISING PHYSICIAN)
- **Authorized official phone:** (573) 825-6097

## Contact information

- **Practice address:** 2221 PEACHTREE RD NE STE Q, ATLANTA, GA 30309-1106
- **Practice address phone:** (404) 343-4973
- **Mailing address:** 2221 PEACHTREE RD NE STE Q, ATLANTA, GA 30309-1106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 7919 | GA | Yes |

## Other

- **Enumeration date:** 04/28/2017
- **Last updated:** 04/28/2017