Healthcare Provider Details

I. General information

NPI: 1629102579
Provider Name (Legal Business Name): THRIVE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HEALTH LN
WARWICK RI
02886-2711
US

IV. Provider business mailing address

50 HEALTH LN
WARWICK RI
02886-2711
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-5656
  • Fax: 401-738-8634
Mailing address:
  • Phone: 401-732-5656
  • Fax: 401-738-8634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number630
License Number StateRI

VIII. Authorized Official

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