Organization
THRIVE BEHAVIORAL NETWORK IV, LLC
Active
Other names
Transformative Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY JOHN BRADLEY (PRESIDENT)
(612) 385-7857
Entity
Organization
Contact information
Practice address
119 FRIBERG AVE, SUITE B, FERGUS FALLS, MN 56537-2251
(218) 531-1528
(218) 531-1586
Mailing address
107 DOCTORS PARK, SAINT CLOUD, MN 56303-1207
(320) 255-9530
(320) 251-2996
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1093571
MN
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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