MEDICARE: THRIVE TREATMENT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	103TA0400X	Addiction (Substance Use Disorder) Psychologist
5	251S00000X	Community/Behavioral Health Agency
6	261Q00000X	Clinic/Center
7	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
8	261QM0850X	Adult Mental Health Clinic/Center
9	261QM0855X	Adolescent and Children Mental Health Clinic/Center
10	261QM1300X	Multi-Specialty Clinic/Center
11	261QM2800X	Methadone Clinic
12	261QP3300X	Pain Clinic/Center
13	261QR0400X	Rehabilitation Clinic/Center
14	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
15	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1255876546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE TREATMENT

Provider Business Mailing Address
First Line	:	1259 BARTLETT COVE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067-3512
Country	:	US
Telephone Number	:	346-220-6551
Fax Number	:	346-220-6552

Provider Business Practice Location Address
First Line	:	1259 BARTLETT COVE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067-3512
Country	:	US
Telephone Number	:	346-220-6551
Fax Number	:	346-220-6552

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. DONALD JUAN WARD JR.
Credential	:
Telephone Number	:	346-220-6551

Provider Enumeration Date	:	12/22/2016
Last Update Date	:	12/22/2016

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Directions to “THRIVE TREATMENT ” Practice Location

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