Thrive Home Agency, LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in West Plains, MO. Organization (NPI-2).
Details
- NPI
- 1982247326
- Entity type
- Organization (NPI-2)
- Legal business name
- Thrive Home Agency, LLC
- Organization subpart
- No
- Enumeration date
- Oct 17, 2019
- Last updated
- Oct 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
408 Washington AveWest Plains, MO 65775-3424
Phone 417-372-1348 · Fax 417-255-8799
Mailing address
408 Washington AveWest Plains, MO 65775-3424
Phone 417-372-1348 · Fax 417-255-8799
Authorized official
Jacqueline Ann Sisco
Co-Owner/Administrator
4173721348
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