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General NPI Number Information
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NPI Number | 1376244335
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Entity Type | Organization
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Legal Business Name | THRIVE BEHAVIOR THERAPY
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 3801 SW 153RD CT
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City | MIAMI
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State | FL
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Zip | 33185-4706
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Country | US
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Telephone | 305-766-3097
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Fax |
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Provider Business Mailing Address
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Address Line | 14310 SW 8TH STREET P.O. BOX 940194
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City | MIAMI
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State | FL
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Zip | 33194
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Country | US
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Telephone | 305-766-3097
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | MRS. AMANDA LIANE RUGAMA LEIVA
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Credential | MS
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Telephone | 305-766-3097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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