Provider Demographics
NPI:1578335311
Name:THRIVE ON
Entity Type:Organization
Organization Name:THRIVE ON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCRIBNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-758-5177
Mailing Address - Street 1:376 E 2ND AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-3188
Mailing Address - Country:US
Mailing Address - Phone:503-758-5177
Mailing Address - Fax:
Practice Address - Street 1:57 S 1100 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1508
Practice Address - Country:US
Practice Address - Phone:503-758-5177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty