Organization
THRIVE PEDIATRIC NURSING INC
Active
Other names
Thrive At Home
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE M MANTUANO (PRESIDENT)
(870) 247-6131
Entity
Organization
Contact information
Practice address
7197 SHERIDAN RD STE 105, WHITE HALL, AR 71602-3261
(870) 247-6131
Mailing address
7197 SHERIDAN RD STE 105, WHITE HALL, AR 71602-3261
(870) 247-6131
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
AR5369
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224683738
—
AR
05
—
235534514
—
AR
01
—
AR5369
ARKANSAS HOME HEALTH CLASS B
AR
01
—
AR5480
CLASS A AND B DERIVITIVE
AR
01
—
AR5648
CLASS B (NEW)
AR
Enumeration date
01/04/2018
Last updated
08/21/2023
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