Provider Demographics
NPI:1376244335
Name:THRIVE BEHAVIOR THERAPY
Entity Type:Organization
Organization Name:THRIVE BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LIANE
Authorized Official - Last Name:RUGAMA LEIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:305-766-3097
Mailing Address - Street 1:14310 SW 8TH STREET
Mailing Address - Street 2:P.O. BOX 940194
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194
Mailing Address - Country:US
Mailing Address - Phone:305-766-3097
Mailing Address - Fax:
Practice Address - Street 1:3801 SW 153RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4706
Practice Address - Country:US
Practice Address - Phone:305-766-3097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health