Provider Demographics
NPI:1619632924
Name:A.C. MOORE USA CO., L.L.C.
Entity Type:Organization
Organization Name:A.C. MOORE USA CO., L.L.C.
Other - Org Name:THRIVE COUNSELING AND PSYCHOTHERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:606-471-9423
Mailing Address - Street 1:PO BOX # 3
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-0003
Mailing Address - Country:US
Mailing Address - Phone:606-471-9423
Mailing Address - Fax:
Practice Address - Street 1:172 TOWN HILL RD STE 5
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-6389
Practice Address - Country:US
Practice Address - Phone:606-471-9423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty