Provider Demographics
NPI:1811703283
Name:THRIVE HEALTH, LLC.
Entity type:Organization
Organization Name:THRIVE HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARKNESS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-400-3165
Mailing Address - Street 1:1507 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-4555
Mailing Address - Country:US
Mailing Address - Phone:678-400-3165
Mailing Address - Fax:
Practice Address - Street 1:1507 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-4555
Practice Address - Country:US
Practice Address - Phone:678-400-3165
Practice Address - Fax:706-998-4183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care