# LIFE THRIVE WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184309288
- **Authorized official:** DESIREE MOORES MOTR/L (OWNER)
- **Authorized official phone:** (208) 741-0395

## Contact information

- **Practice address:** 270 S ORCHARD ST STE B, BOISE, ID 83705-1234
- **Practice address phone:** (208) 741-0395
- **Practice address fax:** (208) 473-7340
- **Mailing address:** 1729 E BOISE AVE, BOISE, ID 83706-5403
- **Mailing address phone:** (208) 741-0395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/16/2023
- **Last updated:** 06/16/2023