Organization Active NPI

Thrive Residential Facility LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
National Provider Identifier
1235011149
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
THRIVE RESIDENTIAL FACILITY LLC
Practice address
12717 SE Lincoln St
Portland, OR 97233-1372
Phone
(215) 960-6390
NPI assigned
Jul 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
Tahseen GillNPI 1275127748
Title
Owner
Phone
(215) 960-6390

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
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

12717 SE Lincoln St
Portland, OR 97233-1372

Mailing address

12717 SE Lincoln St
Portland, OR 97233-1372

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": "1753142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1235011149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12717 SE LINCOLN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12717 SE LINCOLN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331372",
            "telephone_number": "215-960-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE RESIDENTIAL FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "TAHSEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-960-6390"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.