Provider Demographics
NPI:1336779560
Name:THRIVE BEHAVIOR HEALTH AND COUNSELING CENTER
Entity Type:Organization
Organization Name:THRIVE BEHAVIOR HEALTH AND COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-350-2863
Mailing Address - Street 1:9779 GOOD LUCK RD APT 5
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3338
Mailing Address - Country:US
Mailing Address - Phone:240-350-2863
Mailing Address - Fax:
Practice Address - Street 1:9779 GOOD LUCK RD APT 5
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3338
Practice Address - Country:US
Practice Address - Phone:240-350-2863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility