Provider Demographics
NPI:1104091669
Name:THRIVE BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:THRIVE BEHAVIORAL HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/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 1:2756 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-3003
Mailing Address - Country:US
Mailing Address - Phone:401-691-6000
Mailing Address - Fax:
Practice Address - Street 1:2756 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3003
Practice Address - Country:US
Practice Address - Phone:401-691-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI650OtherLICENSE
RI650.04OtherSTATE LICENSE
RI650.05OtherSTATE OF RI LICENSES
RI9001843Medicaid
RI650.3OtherSTATE LICENSE
650.06OtherSTATE LICENSES