Provider Demographics
NPI:1003662958
Name:THRIVE HEALING LLC
Entity type:Organization
Organization Name:THRIVE HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROMAN-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-988-0420
Mailing Address - Street 1:22 RIQUEZA
Mailing Address - Street 2:VILLA CALIZ I
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:404-988-0420
Mailing Address - Fax:
Practice Address - Street 1:295 PALMAS INN WAY STE 125
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-6253
Practice Address - Country:US
Practice Address - Phone:404-988-0420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1174395909Medicaid