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General NPI Number Information
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NPI Number | 1659965705
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Entity Type | Organization
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Legal Business Name | THRIVE REAL LIFE INDEPENDENCE, LLC
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 108 PATRIOT DR STE A
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City | MIDDLETOWN
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State | DE
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Zip | 19709-8803
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Country | US
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Telephone | 302-261-3530
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Fax | 302-376-3081
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Provider Business Mailing Address
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Address Line | 108 PATRIOT DR STE A
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City | MIDDLETOWN
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State | DE
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Zip | 19709-8803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | JOSEPH F RICHICHI
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Credential |
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Telephone | 302-261-3530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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