Healthcare Provider Details

I. General information

NPI: 1609781665
Provider Name (Legal Business Name): VIDA STRONG 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 N MOUNTAIN AVE # B178
UPLAND CA
91786-3695
US

IV. Provider business mailing address

1042 N MOUNTAIN AVE # B178
UPLAND CA
91786-3695
US

V. Phone/Fax

Practice location:
  • Phone: 909-377-6441
  • Fax:
Mailing address:
  • Phone: 909-377-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TISHA ARMSTRONG
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 909-377-6441