Healthcare Provider Details

I. General information

NPI: 1356186522
Provider Name (Legal Business Name): THRIVE HEALTH HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N CHURCH ST STE 26129
WILMINGTON DE
19802-4447
US

IV. Provider business mailing address

2810 N CHURCH ST STE 26129
WILMINGTON DE
19802-4447
US

V. Phone/Fax

Practice location:
  • Phone: 406-560-7083
  • Fax:
Mailing address:
  • Phone: 484-289-0061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMBER GILL
Title or Position: CEO
Credential:
Phone: 406-560-7083