Provider Demographics
NPI:1972843217
Name:THRIVE AUTISM SERVICES
Entity Type:Organization
Organization Name:THRIVE AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-730-9106
Mailing Address - Street 1:300 W LOMBARD ST
Mailing Address - Street 2:APT 811
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2520
Mailing Address - Country:US
Mailing Address - Phone:570-730-9106
Mailing Address - Fax:
Practice Address - Street 1:191 FARMERS RIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7980
Practice Address - Country:US
Practice Address - Phone:570-730-9106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health