Provider Demographics
NPI:1508633728
Name:THRIVE AT HOME, LLC
Entity Type:Organization
Organization Name:THRIVE AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:GODKIN
Authorized Official - Last Name:CRANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:608-572-7537
Mailing Address - Street 1:517 CHARLES LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1311
Mailing Address - Country:US
Mailing Address - Phone:608-332-9749
Mailing Address - Fax:608-200-9017
Practice Address - Street 1:517 CHARLES LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1311
Practice Address - Country:US
Practice Address - Phone:608-572-7537
Practice Address - Fax:608-200-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty