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General NPI Number Information
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NPI Number | 1649168766
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Entity Type | Organization
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Legal Business Name | THRIVEWELL HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 26 RED ROBIN CT
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City | PORT WENTWORTH
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State | GA
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Zip | 31407-3637
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Country | US
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Telephone | 912-223-8023
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Fax |
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Provider Business Mailing Address
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Address Line | 26 RED ROBIN CT
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City | PORT WENTWORTH
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State | GA
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Zip | 31407-3637
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Country | US
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Telephone | 912-223-8023
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MS. YOSHI LEATRICE JONES
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Credential |
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Telephone | 912-223-8023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 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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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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