Provider Demographics
NPI:1760113039
Name:THRIVE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:THRIVE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MUNA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-433-7337
Mailing Address - Street 1:14125 VIRGINIA AVE S STE 106
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2652
Mailing Address - Country:US
Mailing Address - Phone:612-433-7337
Mailing Address - Fax:
Practice Address - Street 1:4106 SCOTT AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-1754
Practice Address - Country:US
Practice Address - Phone:612-433-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health