Healthcare Provider Details

I. General information

NPI: 1851084974
Provider Name (Legal Business Name): STRIVE 365
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 W BLUE SKY DR
PHOENIX AZ
85085-4765
US

IV. Provider business mailing address

2511 W BLUE SKY DR
PHOENIX AZ
85085-4765
US

V. Phone/Fax

Practice location:
  • Phone: 602-312-8504
  • Fax:
Mailing address:
  • Phone: 602-312-8504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LISA MASTERS
Title or Position: CEO
Credential:
Phone: 602-312-8504