Healthcare Provider Details

I. General information

NPI: 1225792278
Provider Name (Legal Business Name): STRIVE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 TIMBER RIDGE DR S
COTTAGE GROVE MN
55016-4776
US

IV. Provider business mailing address

6809 TIMBER RIDGE DR S
COTTAGE GROVE MN
55016-4776
US

V. Phone/Fax

Practice location:
  • Phone: 320-492-1364
  • Fax:
Mailing address:
  • Phone: 320-492-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CURTIS BRYAN JOHNSON
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 320-492-1364