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General NPI Number Information
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NPI Number | 1194566844
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Entity Type | Organization
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Legal Business Name | THRIVING CARE LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1875 PLAZA DR STE 12
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City | EAGAN
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State | MN
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Zip | 55122-2613
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Country | US
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Telephone | 612-716-8019
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Fax | 651-858-3283
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Provider Business Mailing Address
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Address Line | 1875 PLAZA DR STE 12
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City | EAGAN
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State | MN
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Zip | 55122-2613
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Country | US
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Telephone | 612-716-8019
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Fax | 651-858-3283
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Authorized Official
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Title or Position | OWNER
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Name | HUSSEIN KOSSAR HASSAN
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Credential |
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Telephone | 612-716-8019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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