Healthcare Provider Details

I. General information

NPI: 1972485472
Provider Name (Legal Business Name): STRIVUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 OLD HWY 49
CLARKSDALE MS
38614
US

IV. Provider business mailing address

2527 VANDEVER RD # B
CROSSVILLE TN
38572-3317
US

V. Phone/Fax

Practice location:
  • Phone: 931-200-3633
  • Fax:
Mailing address:
  • Phone: 931-200-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LEONA SELBY WAITES
Title or Position: STEERING COMMITTEE CHAIR
Credential:
Phone: 931-200-3633