Healthcare Provider Details

I. General information

NPI: 1962292383
Provider Name (Legal Business Name): THRIVE2SURVIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEWEY HOUSE 2409 CARLSON ROAD
VANCOUVER WA
98661
US

IV. Provider business mailing address

1101 BROADWAY ST STE 130
VANCOUVER WA
98660-3319
US

V. Phone/Fax

Practice location:
  • Phone: 360-831-3118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHARLES HANSET SR.
Title or Position: DIRECTOR OF HOUSING
Credential: CRM II
Phone: 503-901-7471