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General NPI Number Information
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NPI Number | 1366260168
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Entity Type | Organization
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Legal Business Name | STRIVE SOBER LIVING LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 43619 17TH ST W STE 101
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City | LANCASTER
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State | CA
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Zip | 93534-4626
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Country | US
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Telephone | 818-812-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 10151 E AVENUE Q10
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City | LITTLEROCK
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State | CA
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Zip | 93543-4118
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Country | US
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Telephone | 818-812-8455
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSE L ESTRADA
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Credential |
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Telephone | 818-812-8455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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