MEDICARE: THRIVE THERAPY NV PLLC / ELITE OCCUPATIONAL THERAPY SERVICES

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

General Provider Information

NPI Number	:	1225801574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE THERAPY NV PLLC / ELITE OCCUPATIONAL THERAPY SERVICES

Provider Business Mailing Address
First Line	:	1575 W HORIZON RIDGE PKWY #531396
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-3503
Country	:	US
Telephone Number	:	310-728-5523
Fax Number	:

Provider Business Practice Location Address
First Line	:	3024 MISTY HARBOUR DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3503
Country	:	US
Telephone Number	:	310-728-5523
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	DR. TIFFANY NICOLE BRIJBAG
Credential	:	OTD,OTR/L,ASDCS,PN
Telephone Number	:	310-728-5523

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	10/30/2023

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