Provider Demographics
NPI:1811873250
Name:LUMITHRIVE HEALTH
Entity type:Organization
Organization Name:LUMITHRIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PA
Authorized Official - Middle Name:
Authorized Official - Last Name:VUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:559-478-3736
Mailing Address - Street 1:191 E BARSTOW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:191 E BARSTOW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5003
Practice Address - Country:US
Practice Address - Phone:559-478-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals