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General NPI Number Information
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NPI Number | 1295290658
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Entity Type | Organization
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Legal Business Name | THRIVE THERAPY, INC.
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Dates
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Enumeration Date | 02/09/2019
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Last Update Date | 02/09/2019
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Provider Practice Location Address
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Address Line | 12240 VENICE BLVD STE 26
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City | LOS ANGELES
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State | CA
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Zip | 90066-3891
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Country | US
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Telephone | 323-999-1537
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Fax |
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Provider Business Mailing Address
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Address Line | 12240 VENICE BLVD STE 26
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City | LOS ANGELES
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State | CA
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Zip | 90066-3891
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Country | US
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Telephone | 310-699-6993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY MCMANUS
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Credential |
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Telephone | 323-999-1537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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