Provider Demographics
NPI:1033945886
Name:THRIVEWELL LLC
Entity type:Organization
Organization Name:THRIVEWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MINEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-333-9428
Mailing Address - Street 1:77 RIDEOUT AVE APT 15-3
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-3474
Mailing Address - Country:US
Mailing Address - Phone:207-333-9428
Mailing Address - Fax:
Practice Address - Street 1:77 RIDEOUT AVE APT 15-3
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3474
Practice Address - Country:US
Practice Address - Phone:207-333-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty