Provider Demographics
| NPI: | 1255876546 |
|---|---|
| Name: | THRIVE TREATMENT |
| Entity type: | Organization |
| Organization Name: | THRIVE TREATMENT |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | MANAGING DIRECTOR |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | DONALD |
| Authorized Official - Middle Name: | JUAN |
| Authorized Official - Last Name: | WARD |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 346-220-6551 |
| Mailing Address - Street 1: | 1259 BARTLETT COVE DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77067-3512 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 346-220-6551 |
| Mailing Address - Fax: | 346-220-6552 |
| Practice Address - Street 1: | 1259 BARTLETT COVE DR |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77067-3512 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 346-220-6551 |
| Practice Address - Fax: | 346-220-6552 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2016-12-22 |
| Last Update Date: | 2016-12-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | Methadone | |
| No | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center | Pain | |
| No | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
