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THRIVE BEHAVIORAL NETWORK III LLC NPI 1659598894


NPI Information

NPI: 1659598894
Provider Name: THRIVE BEHAVIORAL NETWORK III, LLC

Doing Business As: WILLOW HAVEN

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
3819 LAVERN AVE N
LAKE ELMO, MN
ZIP 55042
Phone: (651) 770-2224
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THRIVE BEHAVIORAL NETWORK III, LLC is a community based residential treatment facility mental illness in Lake Elmo, MN. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. THRIVE BEHAVIORAL NETWORK III, LLC NPI is 1659598894. The provider is registered as an organization entity type.
The provider Is Doing Business As Willow Haven.

The provider's business location address is:

3819 LAVERN AVE N
LAKE ELMO, MN
ZIP 55042-629
Phone: (651) 770-2224
Fax: (651) 773-6501

The provider's authorized official is Jeff Bradley .
The authorized official title is President and has the following contact phone number (612) 385-7857.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 11/8/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320800000XCommunity Based Residential Treatment Facility, Mental Illness81011-3-RMIMINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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