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Organization
THRIVE COMMUNITY OUTREACH
Active
Organization
THRIVE COMMUNITY OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAREN LAZZARI NP (PRESIDENT)
(770) 449-2151
Entity
Organization
Contact information
Practice address
230 S CULVER ST, LAWRENCEVILLE, GA 30046-4806
(770) 449-2151
Mailing address
230 S CULVER ST, LAWRENCEVILLE, GA 30046-4806
(770) 449-2151
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
028884
GA
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN124271
GA
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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