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General NPI Number Information
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NPI Number | 1790415685
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Entity Type | Organization
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Legal Business Name | THRIVE DIRECT CARE
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 1011 TUNNEL RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-2058
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Country | US
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Telephone | 508-308-1024
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Fax |
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Provider Business Mailing Address
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Address Line | 104 RICHARDSON BLVD UNIT 1113
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-3683
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Country | US
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Telephone | 508-308-1024
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MITCHELL LI
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Credential | MD
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Telephone | 508-308-1024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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