Provider Demographics
NPI:1629102579
Name:THRIVE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:THRIVE BEHAVIORAL HEALTH
Other - Org Name:THRIVE BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUBAS MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-691-0000
Mailing Address - Street 1:50 HEALTH LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2711
Mailing Address - Country:US
Mailing Address - Phone:401-732-5656
Mailing Address - Fax:401-738-8634
Practice Address - Street 1:50 HEALTH LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2711
Practice Address - Country:US
Practice Address - Phone:401-732-5656
Practice Address - Fax:401-738-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI630261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKC15427Medicaid