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General NPI Number Information
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NPI Number | 1407584741
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Entity Type | Organization
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Legal Business Name | THRIVELIFE HEALTHCARE LLC
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Dates
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Enumeration Date | 08/14/2022
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Last Update Date | 08/14/2022
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Provider Practice Location Address
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Address Line | 1350 S GREENFIELD RD UNIT 2041
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City | MESA
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State | AZ
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Zip | 85206-3556
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Country | US
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Telephone | 602-578-9497
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 S GREENFIELD RD UNIT 2041
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City | MESA
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State | AZ
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Zip | 85206-3556
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Country | US
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Telephone | 602-578-9497
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MEKESHA COPELAND
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Credential |
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Telephone | 602-578-9497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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