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NPI Code Detail

MEDICARE: LIFE STRIDE, INC.

MEDICARE: LIFE STRIDE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
3101YA0400XAddiction (Substance Use Disorder) Counselor
4261QA0600XAdult Day Care Clinic/Center
5261QH0100XHealth Service Clinic/Center
6261QM0850XAdult Mental Health Clinic/Center
7261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)036685200DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851441588
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE STRIDE, INC.
Provider Business Mailing Address
First Line : 3005 BLADENSBURG RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-2265
Country : US
Telephone Number : 202-635-2320
Fax Number : 202-635-0752
Provider Business Practice Location Address
First Line : 3005 BLADENSBURG RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-2265
Country : US
Telephone Number : 202-635-2320
Fax Number : 202-635-0752
Authorized Official
Title or Position : CEO
Name : MS. JOYCE L DRUMMING
Credential : LICSW
Telephone Number : 202-635-2320
Provider Enumeration Date : 01/12/2007
Last Update Date : 03/05/2021

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Directions to “LIFE STRIDE, INC. ” Practice Location

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