Provider Demographics
NPI:1619559119
Name:THRIVE KAUAI, LLC
Entity Type:Organization
Organization Name:THRIVE KAUAI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:PARRENO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:702-900-8086
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-0397
Mailing Address - Country:US
Mailing Address - Phone:702-900-8086
Mailing Address - Fax:
Practice Address - Street 1:3575 LAUOHO RD
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741
Practice Address - Country:US
Practice Address - Phone:702-900-8086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty