Provider Demographics
NPI:1609354968
Name:THRIVE IN-HOME REHAB, LLC
Entity Type:Organization
Organization Name:THRIVE IN-HOME REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRITTING
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS
Authorized Official - Phone:682-235-8627
Mailing Address - Street 1:6387B CAMP BOWIE BLVD # 313
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-5423
Mailing Address - Country:US
Mailing Address - Phone:682-235-8627
Mailing Address - Fax:866-710-6897
Practice Address - Street 1:4913 BUCKING BRONC DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76126-6467
Practice Address - Country:US
Practice Address - Phone:682-235-8627
Practice Address - Fax:866-710-6897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11565562251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty