Provider Demographics
NPI:1508603382
Name:THRIVE CARE LLC
Entity type:Organization
Organization Name:THRIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:940-882-2622
Mailing Address - Street 1:1326 S 14TH ST STE D-D1
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-3743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1326 S 14TH ST STE D-D1
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-3743
Practice Address - Country:US
Practice Address - Phone:940-882-2622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care