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General NPI Number Information
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NPI Number | 1437962396
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Entity Type | Organization
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Legal Business Name | THRIVE CENTRAL OREGON
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 231 NW IDAHO AVE
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City | BEND
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State | OR
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Zip | 97703-2685
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Country | US
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Telephone | 541-728-1022
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1815
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City | BEND
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State | OR
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Zip | 97709-1815
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Country | US
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Telephone | 541-527-9871
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Fax |
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Authorized Official
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Title or Position | ED
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Name | SARAH MAHNKE
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Credential |
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Telephone | 541-728-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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