Healthcare Provider Details
I. General information
NPI: 1194384818
Provider Name (Legal Business Name): THRIVE ADULT DAY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2019
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8720 HARRIS RD UNIT 101
BAKERSFIELD CA
93311-9846
US
IV. Provider business mailing address
2955 E. HILLCREST DR SUITE 129
THOUSAND OAKS CA
91362
US
V. Phone/Fax
- Phone: 805-917-2005
- Fax: 805-917-2003
- Phone: 805-917-2005
- Fax: 805-917-2003
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
SILLARS
Title or Position: ADMINISTRATOR
Credential: LCSW, MSW
Phone: 805-917-2005