MEDICARE: THRIVE HEALTH CARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HCO-1836	VA

General Provider Information

NPI Number	:	1033611488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE HEALTH CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	6299 LEESBURG PIKE STE C
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2101
Country	:	US
Telephone Number	:	703-992-0484
Fax Number	:	571-308-2128

Provider Business Practice Location Address
First Line	:	6299 LEESBURG PIKE STE C
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2101
Country	:	US
Telephone Number	:	703-992-0484
Fax Number	:	571-308-2128

Authorized Official
Title or Position	:	OWNER
Name	:	BLEN ABRAHAM
Credential	:	BSN, RN
Telephone Number	:	703-992-0484

Provider Enumeration Date	:	03/01/2018
Last Update Date	:	03/01/2018

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