Healthcare Provider Details

I. General information

NPI: 1114570173
Provider Name (Legal Business Name): STRIVE THERAPEUTIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S 9TH ST
CLINTON OK
73601-3328
US

IV. Provider business mailing address

PO BOX 741
CLINTON OK
73601-0741
US

V. Phone/Fax

Practice location:
  • Phone: 580-715-1174
  • Fax:
Mailing address:
  • Phone: 580-715-1174
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. AMBER HALLABA
Title or Position: CO-OWNER
Credential:
Phone: 580-715-1174