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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