Provider Demographics
NPI:1306535620
Name:THRIVE BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:THRIVE BEHAVIORAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGOMBA-BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:239-841-6373
Mailing Address - Street 1:7320 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0916
Mailing Address - Country:US
Mailing Address - Phone:813-498-9378
Mailing Address - Fax:813-441-8534
Practice Address - Street 1:7320 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-0916
Practice Address - Country:US
Practice Address - Phone:813-498-9378
Practice Address - Fax:813-441-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty