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General NPI Number Information
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NPI Number | 1508567025
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Entity Type | Organization
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Legal Business Name | THRIVE THERAPY SERVICES INC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 4695 MACARTHUR CT STE 1100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1866
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Country | US
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Telephone | 949-478-4669
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Fax |
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Provider Business Mailing Address
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Address Line | 7739 E PORTOFINO AVE
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City | ANAHEIM
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State | CA
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Zip | 92808-1569
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Country | US
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Telephone | 714-227-7783
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WHITNEY MARIE BOETEL
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Credential |
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Telephone | 714-227-7783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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