Organization
THRIVE ADDICTIONS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ROBERT TROUT LCAS, CCS, MAC (OWNER, CLINICAL SUPERVISOR)
(910) 483-8500
Entity
Organization
Contact information
Practice address
1611B OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 483-8500
(910) 483-5864
Mailing address
1611B OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 483-8500
(910) 483-5864
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
MHL-026-962
NC
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
MHL-026-962
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111996
—
NC
Enumeration date
02/27/2017
Last updated
02/27/2017
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