Organization
THRIVE AUTISM CENTER L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMATALIS HAILLE (OWNER)
(320) 200-2334
Entity
Organization
Contact information
Practice address
110 DIVISION ST, WAITE PARK, MN 56387-1330
(320) 200-2334
Mailing address
110 DIVISION ST, WAITE PARK, MN 56387-1330
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
10/20/2023
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