Provider Demographics
NPI:1174278832
Name:ITHRIVEABA LLC
Entity Type:Organization
Organization Name:ITHRIVEABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-525-2263
Mailing Address - Street 1:10 PRIMROSE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3283
Mailing Address - Country:US
Mailing Address - Phone:848-525-2263
Mailing Address - Fax:
Practice Address - Street 1:2929 W COYLE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2923
Practice Address - Country:US
Practice Address - Phone:848-525-2263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty