Provider Demographics
NPI:1194391672
Name:FIRM FOUNDATION TO THRIVE, LLC
Entity Type:Organization
Organization Name:FIRM FOUNDATION TO THRIVE, LLC
Other - Org Name:FIRM FOUNDATION TO THRIVE HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:410-905-8956
Mailing Address - Street 1:7018 KNIGHTHOOD LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4817
Mailing Address - Country:US
Mailing Address - Phone:410-905-8956
Mailing Address - Fax:
Practice Address - Street 1:7274 CRADLEROCK WAY FL 2
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5069
Practice Address - Country:US
Practice Address - Phone:443-545-5042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness