Organization
THRIVE BEHAVIORAL NETWORK IV, LLC
Active
Organization
THRIVE BEHAVIORAL NETWORK IV, LLC
Active
Other names
New Visions Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BRADLEY (PRESIDENT)
(612) 385-7857
Entity
Organization
Contact information
Practice address
909 BROADWAY, ALEXANDRIA, MN 56308-2204
(320) 763-0124
(320) 763-0126
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
1036380
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
674407900
—
MN
Enumeration date
11/07/2006
Last updated
03/30/2017
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