Healthcare Provider Details

I. General information

NPI: 1184181042
Provider Name (Legal Business Name): STRIVE RECREATIONAL THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6751 DIXIE HWY STE 113
CLARKSTON MI
48346-2080
US

IV. Provider business mailing address

7111 DIXIE HWY # 123
CLARKSTON MI
48346-2077
US

V. Phone/Fax

Practice location:
  • Phone: 248-922-1236
  • Fax: 248-922-1235
Mailing address:
  • Phone: 248-922-1236
  • Fax: 248-922-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: STELLA ARZADON HUSCH
Title or Position: PRESIDENT
Credential: CTRS
Phone: 248-922-1236