| Thrive Holistic Healing Llc | |
|
2761 Richmond Hwy Ste 207 Stafford VA 22554-8329 | |
| (571) 535-7255 | |
| Not Available |
| Full Name | Thrive Holistic Healing Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2761 Richmond Hwy Ste 207, Stafford, Virginia |
| Authorized Official Name and Position | Lataya Toqwue Whitaker (OWNER) |
| Authorized Official Contact | 5715357255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Holistic Healing Llc 2761 Richmond Hwy Ste 207 Stafford VA 22554-8329 Ph: (571) 535-7255 | Thrive Holistic Healing Llc 2761 Richmond Hwy Ste 207 Stafford VA 22554-8329 Ph: (571) 535-7255 |
| NPI Number | 1164157988 |
|---|---|
| Provider Enumeration Date | 07/18/2022 |
| Last Update Date | 10/13/2022 |
| Medicare PECOS PAC ID | 9234505462 |
|---|---|
| Medicare Enrollment ID | O20221013000784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164157988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lataya T Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780124362 PECOS PAC ID: 5294012365 Enrollment ID: I20170524002279 |
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