Provider Demographics
NPI:1013230846
Name:THRIVE PLACE LP
Entity Type:Organization
Organization Name:THRIVE PLACE LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DERINGOR
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:412-421-0310
Mailing Address - Street 1:4070 BEECHWOOD BLVD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2679
Mailing Address - Country:US
Mailing Address - Phone:412-521-1067
Mailing Address - Fax:866-902-6694
Practice Address - Street 1:4070 BEECHWOOD BLVD
Practice Address - Street 2:UNIT 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2679
Practice Address - Country:US
Practice Address - Phone:412-521-1067
Practice Address - Fax:866-902-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003841133V00000X
PAOC006596L225X00000X
PAOC011789225X00000X
PASL006089L235Z00000X
PASL008282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty