Organization
VIVID SPARK LLC
Active
Other names
Vivid spark services
Organization subpart
No
Provider details
NPI number
Authorized official
FARAH S BAIG MD (PART OWNER)
(678) 206-6018
Entity
Organization
Contact information
Practice address
1590 ATKINSON RD STE 101, LAWRENCEVILLE, GA 30043-5674
(678) 206-6018
(678) 669-2659
Mailing address
773 BRENTMEAD DR, LAWRENCEVILLE, GA 30044-6077
(678) 206-6018
(678) 669-2659
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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