Provider Demographics
NPI:1245969583
Name:THRIVE HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:THRIVE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANANI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-207-5123
Mailing Address - Street 1:142 W KESTREL DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6014
Mailing Address - Country:US
Mailing Address - Phone:385-207-5123
Mailing Address - Fax:
Practice Address - Street 1:142 W KESTREL DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-6014
Practice Address - Country:US
Practice Address - Phone:385-207-5123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services