Healthcare Provider Details

I. General information

NPI: 1508732934
Provider Name (Legal Business Name): THRIVE HAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3319 99TH ST
CORONA NY
11368-1025
US

IV. Provider business mailing address

4019 159TH ST STE B-A
FLUSHING NY
11358-1668
US

V. Phone/Fax

Practice location:
  • Phone: 917-547-7004
  • Fax:
Mailing address:
  • Phone: 917-547-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DANNY LING
Title or Position: OWNER
Credential:
Phone: 917-547-7004