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General NPI Number Information
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NPI Number | 1275195596
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Entity Type | Organization
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Legal Business Name | STRIDE SERVICES, LLC
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 101 E PARK BLVD STE 600
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City | PLANO
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State | TX
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Zip | 75074-8818
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Country | US
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Telephone | 214-282-0258
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Fax |
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Provider Business Mailing Address
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Address Line | 5303 DONOVAN CT
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City | ROWLETT
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State | TX
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Zip | 75088-6889
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | HEATHER BLASINGAME
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Credential |
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Telephone | 214-282-0258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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