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General NPI Number Information
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NPI Number | 1750229209
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Entity Type | Organization
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Legal Business Name | THRIVE COMMUNITY SERVICES, LLC
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 12553 W EXPLORER DR STE 190
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City | BOISE
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State | ID
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Zip | 83713-1612
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Country | US
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Telephone | 208-376-7083
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Fax |
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Provider Business Mailing Address
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Address Line | 16113 ABIGAIL ST
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City | BENNINGTON
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State | NE
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Zip | 68007-5183
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Country | US
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Telephone | 208-949-7079
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STACEY M WARNER
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Credential |
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Telephone | 208-949-7079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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