Provider Demographics
NPI:1699581819
Name:THRIVE-MAINE BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:THRIVE-MAINE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-EXECUTIVE DIRECTOR/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-749-3143
Mailing Address - Street 1:510 MAIN ST # 23
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1339
Mailing Address - Country:US
Mailing Address - Phone:207-749-3143
Mailing Address - Fax:
Practice Address - Street 1:510 MAIN ST # 23
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1339
Practice Address - Country:US
Practice Address - Phone:207-749-3143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty