Provider Demographics
NPI:1023554508
Name:THRIVE. MINDFULNESS AND MOTION
Entity Type:Organization
Organization Name:THRIVE. MINDFULNESS AND MOTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:970-412-2675
Mailing Address - Street 1:3082 E 106TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-6111
Mailing Address - Country:US
Mailing Address - Phone:970-412-2675
Mailing Address - Fax:
Practice Address - Street 1:3082 E 106TH PL
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-6111
Practice Address - Country:US
Practice Address - Phone:970-412-2675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health