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General NPI Number Information
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NPI Number | 1508793282
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Entity Type | Organization
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Legal Business Name | THRIVE PSYCHIATRIC WELLNESS LLC
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 1111 W IRONWOOD DR STE B
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2604
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Country | US
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Telephone | 208-664-1594
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 46
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City | SANDPOINT
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State | ID
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Zip | 83864-0046
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Country | US
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Telephone | 970-457-7973
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | ROBERT KYLE WEAVER
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Credential | APRN-CNP
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Telephone | 208-664-1594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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