Provider Demographics
NPI:1760258636
Name:THRIVING LIFE HOMECARE LLC
Entity Type:Organization
Organization Name:THRIVING LIFE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-973-6086
Mailing Address - Street 1:2276 E CAMBRIA ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-3906
Mailing Address - Country:US
Mailing Address - Phone:844-305-9184
Mailing Address - Fax:
Practice Address - Street 1:2276 E CAMBRIA ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19134-3906
Practice Address - Country:US
Practice Address - Phone:844-305-9184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health