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Contact Information

THRIVE COMMUNITY OUTREACH
230 S CULVER ST
LAWRENCEVILLE, GA30046-4806
 Phone: 770-449-2151
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health, Child & Family

364SP0810X 89 Certified Clinical Nurse Specialist
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for THRIVE COMMUNITY OUTREACH · (Female)

NPI # 1316335078
Status Active
Credentials
Entity Individual
Enumeration date 01/05/2015
Last updated 01/05/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 028884
  • GA License # RN124271
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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