Healthcare Provider Details

I. General information

NPI: 1861242125
Provider Name (Legal Business Name): THRIVE ONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15320 BOSTON PKWY APT 108
CLIVE IA
50325-4705
US

IV. Provider business mailing address

15320 BOSTON PKWY APT 108
CLIVE IA
50325-4705
US

V. Phone/Fax

Practice location:
  • Phone: 515-864-9050
  • Fax:
Mailing address:
  • Phone: 515-864-9050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ODETTE M. KARANI
Title or Position: OWNER
Credential:
Phone: 515-864-9050