Provider Demographics
NPI:1043091010
Name:THRIVE MODERN HEALTH P.A.
Entity Type:Organization
Organization Name:THRIVE MODERN HEALTH P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BELSETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-730-2237
Mailing Address - Street 1:7101 YORK AVE S STE 157
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4420
Mailing Address - Country:US
Mailing Address - Phone:612-386-7939
Mailing Address - Fax:
Practice Address - Street 1:7101 YORK AVE S STE 157
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4420
Practice Address - Country:US
Practice Address - Phone:612-254-6414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty