NPIMap

Organization Active NPI

Thrive Autism Center L.L.C.

  • Clinic/Center
  • Waite Park, MN
National Provider Identifier
1023794229
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
THRIVE AUTISM CENTER L.L.C.
Practice address
110 Division St
Waite Park, MN 56387-1330
Phone
(320) 200-2334
NPI assigned
Jun 23, 2023
Last updated
Oct 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samatalis HailleNPI 1912664079
Title
Owner
Phone
(320) 200-2334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

110 Division St
Waite Park, MN 56387-1330

Mailing address

110 Division St
Waite Park, MN 56387-1330

National Provider Directory

National Provider Directory

Locations

110 Division St
Waite Park, MN 56387
Phone (320) 342-2031

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 60

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1023794229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DIVISION ST",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DIVISION ST",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871330",
            "telephone_number": "320-200-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE AUTISM CENTER L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "HAILLE",
        "authorized_official_first_name": "SAMATALIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-200-2334"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.