Healthcare Provider Details

I. General information

NPI: 1801201355
Provider Name (Legal Business Name): STRIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 N AMIDON AVE 404
WICHITA KS
67204-4900
US

IV. Provider business mailing address

2727 N AMIDON AVE 404
WICHITA KS
67204-4900
US

V. Phone/Fax

Practice location:
  • Phone: 316-409-9226
  • Fax:
Mailing address:
  • Phone: 316-409-9226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateKS

VIII. Authorized Official

Name: ADRIEN SCHULTE
Title or Position: OWNER
Credential:
Phone: 316-409-9226