Provider Demographics
NPI:1255139275
Name:THRIVE BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:THRIVE BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-960-0797
Mailing Address - Street 1:1730 GRAHAM AVE APT 309
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3269
Mailing Address - Country:US
Mailing Address - Phone:303-960-0797
Mailing Address - Fax:
Practice Address - Street 1:1730 GRAHAM AVE APT 309
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3269
Practice Address - Country:US
Practice Address - Phone:303-960-0697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AA SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)