Provider Demographics
NPI:1598272841
Name:THRIVE RELATIONAL RECOVERY
Entity Type:Organization
Organization Name:THRIVE RELATIONAL RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCIAL DIRECTOR AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNUDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-201-1524
Mailing Address - Street 1:6551 S REVERE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6551 S REVERE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-6470
Practice Address - Country:US
Practice Address - Phone:303-886-6092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty