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Organization

THERATHRIVE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUZANNE BENITES LCSW (MEMBER/MANAGER)
(817) 899-5904
Entity
Organization

Contact information

Practice address
601 STRADA CIR STE 102, MANSFIELD, TX 76063-3219
(817) 899-5904
Mailing address
1516 HAMPTON DR, MANSFIELD, TX 76063-7915
(817) 899-5904

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
09/16/2019
Last updated
07/31/2020
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