Provider Demographics
NPI:1356852552
Name:THRIVING LIVES INC.
Entity Type:Organization
Organization Name:THRIVING LIVES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:734-846-7177
Mailing Address - Street 1:42000 6 MILE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4374
Mailing Address - Country:US
Mailing Address - Phone:248-283-3703
Mailing Address - Fax:
Practice Address - Street 1:42000 6 MILE RD STE 202
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-4374
Practice Address - Country:US
Practice Address - Phone:248-283-3703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015927103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty