Provider Demographics
NPI:1063389880
Name:THRIVE777
Entity type:Organization
Organization Name:THRIVE777
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:SELEST
Authorized Official - Last Name:SIVORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-497-8995
Mailing Address - Street 1:PO BOX 11235
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95406-1235
Mailing Address - Country:US
Mailing Address - Phone:707-497-8995
Mailing Address - Fax:
Practice Address - Street 1:199 E GOBBI ST STE 100
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5570
Practice Address - Country:US
Practice Address - Phone:707-497-8995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care