Organization
THRIVE HOME AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ANN SISCO (CO-OWNER/ADMINISTRATOR)
(417) 372-1348
Entity
Organization
Contact information
Practice address
408 WASHINGTON AVE, WEST PLAINS, MO 65775-3424
(417) 372-1348
(417) 255-8799
Mailing address
408 WASHINGTON AVE, WEST PLAINS, MO 65775-3424
(417) 372-1348
(417) 255-8799
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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