Provider Demographics
NPI:1457114944
Name:TRIVE TRU HEALTH SERVICES INC
Entity type:Organization
Organization Name:TRIVE TRU HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIVINE
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:EZEWUZIE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:857-251-9231
Mailing Address - Street 1:122 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-7769
Mailing Address - Country:US
Mailing Address - Phone:857-251-9231
Mailing Address - Fax:
Practice Address - Street 1:7 LINCOLN ST STE 201
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3033
Practice Address - Country:US
Practice Address - Phone:857-251-9231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty