Provider Demographics
NPI:1790818128
Name:THRIVE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:THRIVE BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUBAS MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-691-0000
Mailing Address - Street 1:300 CENTERVILLE RD
Mailing Address - Street 2:SUITE 301-S
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0200
Mailing Address - Country:US
Mailing Address - Phone:401-732-5656
Mailing Address - Fax:
Practice Address - Street 1:1315 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-4807
Practice Address - Country:US
Practice Address - Phone:401-732-5656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THRIVE BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-14
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI630.7251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKC02233Medicaid