MEDICARE: JASEL THRIVECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251G00000X	Community Based Hospice Care Agency
2	251S00000X	Community/Behavioral Health Agency
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4	385H00000X	Respite Care
5	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1659247062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASEL THRIVECARE LLC

Provider Business Mailing Address
First Line	:	1117 PAWNEE DR NW
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52405-2324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 PAWNEE DR NW
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52405-2324
Country	:	US
Telephone Number	:	319-320-3768
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE
Name	:	SIWACU GIDIONI
Credential	:
Telephone Number	:	319-320-3768

Provider Enumeration Date	:	10/13/2025
Last Update Date	:	10/13/2025

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