Provider Demographics
NPI:1598552317
Name:THRIVEBRIDGE WELLNESS LLC
Entity type:Organization
Organization Name:THRIVEBRIDGE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUSIF
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:SALIH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-644-2372
Mailing Address - Street 1:4389 HODGSON RD
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1921
Mailing Address - Country:US
Mailing Address - Phone:404-644-2372
Mailing Address - Fax:
Practice Address - Street 1:4389 HODGSON RD
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-1921
Practice Address - Country:US
Practice Address - Phone:404-644-2372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)