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General NPI Number Information
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NPI Number | 1457097230
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Entity Type | Organization
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Legal Business Name | STRIVE LOGOPEDICS CENTER CORP
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 04/02/2023
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Provider Practice Location Address
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Address Line | 1906 COMMERCENTER E STE 206
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3424
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Country | US
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Telephone | 951-906-6535
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Fax |
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Provider Business Mailing Address
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Address Line | 3068 CHABLIS AVE
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City | JURUPA VALLEY
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State | CA
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Zip | 92509-1046
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Country | US
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Telephone | 909-567-2035
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GORETTI MORALES
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Credential | OWNER
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Telephone | 909-567-2035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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