Healthcare Provider Details

I. General information

NPI: 1104789247
Provider Name (Legal Business Name): THRIVE HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8180 TARA BLVD
JONESBORO GA
30236-3175
US

IV. Provider business mailing address

8180 TARA BLVD
JONESBORO GA
30236-3175
US

V. Phone/Fax

Practice location:
  • Phone: 770-892-9248
  • Fax:
Mailing address:
  • Phone: 404-717-3014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MAXINE OWUSU
Title or Position: DIRECTOR
Credential: MD
Phone: 404-717-3014