Healthcare Provider Details

I. General information

NPI: 1104091669
Provider Name (Legal Business Name): THRIVE BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2756 POST RD
WARWICK RI
02886-3003
US

IV. Provider business mailing address

2756 POST RD
WARWICK RI
02886-3003
US

V. Phone/Fax

Practice location:
  • Phone: 401-691-6000
  • Fax:
Mailing address:
  • Phone: 401-691-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL KUBAS MEYER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 401-691-0000