Provider Demographics
NPI:1871241125
Name:THRIVE HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:THRIVE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Q
Authorized Official - Last Name:BUSSELL
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:470-399-8529
Mailing Address - Street 1:4425 CARRIAGE TRL
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-5311
Mailing Address - Country:US
Mailing Address - Phone:470-399-8529
Mailing Address - Fax:
Practice Address - Street 1:4425 CARRIAGE TRL
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-5311
Practice Address - Country:US
Practice Address - Phone:470-399-8529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty