Healthcare Provider Details

I. General information

NPI: 1295107019
Provider Name (Legal Business Name): THRIVE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3937 MARQUETTE WAY NW
KENNESAW GA
30144-6044
US

IV. Provider business mailing address

3937 MARQUETTE WAY NW
KENNESAW GA
30144-6044
US

V. Phone/Fax

Practice location:
  • Phone: 770-906-6535
  • Fax: 404-505-9455
Mailing address:
  • Phone: 404-857-3600
  • Fax: 404-505-9455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number11086785
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number11086785
License Number StateGA

VIII. Authorized Official

Name: BRITTANY STEPHENS HILL
Title or Position: CEO
Credential:
Phone: 770-906-6535