Provider Demographics
NPI:1730975640
Name:THRIVE INTEGRATED HEALTHCARE LLC
Entity type:Organization
Organization Name:THRIVE INTEGRATED HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FNP-BC PMHNP-BC
Authorized Official - Prefix:MISS
Authorized Official - First Name:INES INGRID
Authorized Official - Middle Name:TAGNE
Authorized Official - Last Name:ANTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:774-239-1510
Mailing Address - Street 1:634 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-2131
Mailing Address - Country:US
Mailing Address - Phone:774-239-1510
Mailing Address - Fax:
Practice Address - Street 1:46 BEECH ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-2100
Practice Address - Country:US
Practice Address - Phone:413-224-8132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty