Provider Demographics
NPI:1871126565
Name:ARISE AND THRIVE THERAPY SERVICE
Entity type:Organization
Organization Name:ARISE AND THRIVE THERAPY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYHISHA
Authorized Official - Middle Name:PADEN
Authorized Official - Last Name:FASHIPE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:908-265-2688
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30015-0362
Mailing Address - Country:US
Mailing Address - Phone:908-265-2688
Mailing Address - Fax:
Practice Address - Street 1:10920 COVINGTON BY PASS RD APT 504
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-3828
Practice Address - Country:US
Practice Address - Phone:908-265-2688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty