Provider Demographics
NPI:1083204945
Name:THRIVE THERAPEUTICS ASHEVILLE INCORPORATED
Entity Type:Organization
Organization Name:THRIVE THERAPEUTICS ASHEVILLE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:QUANITA
Authorized Official - Last Name:DEADERICK
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:904-327-4848
Mailing Address - Street 1:25 BRADLEY ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-4406
Mailing Address - Country:US
Mailing Address - Phone:828-412-0908
Mailing Address - Fax:
Practice Address - Street 1:190 BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2501
Practice Address - Country:US
Practice Address - Phone:828-412-0908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty