Healthcare Provider Details

I. General information

NPI: 1205799277
Provider Name (Legal Business Name): THRIVE HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10811 RED RUN BLVD
OWINGS MILLS MD
21117-5149
US

IV. Provider business mailing address

10811 RED RUN BLVD
OWINGS MILLS MD
21117-5149
US

V. Phone/Fax

Practice location:
  • Phone: 410-739-9986
  • Fax:
Mailing address:
  • Phone: 410-739-9986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EZINNE ABUMERE
Title or Position: OWNER
Credential:
Phone: 410-739-9986