Healthcare Provider Details
I. General information
NPI: 1982403754
Provider Name (Legal Business Name): THRIVE RESPITE & RELIEF OF SALISBURY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 HENDERLITE ST
SALISBURY NC
28144-3602
US
IV. Provider business mailing address
9900 POPLAR TENT RD STE 115 - 3058
CONCORD NC
28027-9502
US
V. Phone/Fax
- Phone: 980-206-8188
- Fax:
- Phone: 980-206-8188
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GREGORY
HUCKLEBERRY
Title or Position: OWNER/ MANAGER
Credential:
Phone: 980-206-8188