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General NPI Number Information
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NPI Number | 1144508615
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Entity Type | Organization
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Legal Business Name | ITHRIVE HEALTH LLC
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 6009 RICHMOND AVE SUITE 115
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City | HOUSTON
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State | TX
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Zip | 77057-6226
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Country | US
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Telephone | 888-982-8539
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Fax | 888-982-8539
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Provider Business Mailing Address
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Address Line | 2951 MARINA BAY DR 130-542
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City | LEAGUE CITY
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State | TX
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Zip | 77573-2735
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Country | US
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Telephone | 888-982-8539
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Fax | 888-982-8539
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Authorized Official
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Title or Position | OWNER
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Name | GREG RAINBOLT
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Credential |
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Telephone | 888-982-8539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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