Provider Demographics
NPI:1891556585
Name:THRIVE WELLNESS INCORPORATED
Entity Type:Organization
Organization Name:THRIVE WELLNESS INCORPORATED
Other - Org Name:CENTER FOR NEW GROWTH
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:707-267-7931
Mailing Address - Street 1:770 11TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-5838
Mailing Address - Country:US
Mailing Address - Phone:707-267-7931
Mailing Address - Fax:707-306-7253
Practice Address - Street 1:770 11TH ST STE B
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-5838
Practice Address - Country:US
Practice Address - Phone:707-267-7931
Practice Address - Fax:707-306-7253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA