NPIMap

Organization Active NPI

Life Thrive Wellness LLC

  • Occupational Therapist
  • Boise, ID
National Provider Identifier
1184309288
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
LIFE THRIVE WELLNESS LLC
Practice address
270 S Orchard St Ste B
Boise, ID 83705-1234
Phone
(208) 741-0395
Fax
(208) 473-7340
NPI assigned
Jun 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Desiree Moores, MOTR/LNPI 1821400268
Title
Owner
Phone
(208) 741-0395

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
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

270 S Orchard St Ste B
Boise, ID 83705-1234

Mailing address

1729 E Boise Ave
Boise, ID 83706-5403
Phone (208) 741-0395

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1184309288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 E BOISE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065403",
            "telephone_number": "208-741-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 S ORCHARD ST STE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051234",
            "telephone_number": "208-741-0395",
            "fax_number": "208-473-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE THRIVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "MOORES",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-741-0395",
        "authorized_official_credential": "MOTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.