MEDICARE: STRIDENT HEALTHCARE, 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1902342314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRIDENT HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	28116 ORCHARD LAKE RD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3737
Country	:	US
Telephone Number	:	248-550-0333
Fax Number	:	248-876-3015

Provider Business Practice Location Address
First Line	:	28116 ORCHARD LAKE RD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3737
Country	:	US
Telephone Number	:	248-550-0333
Fax Number	:	248-876-3015

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SWARUP SAHA
Credential	:
Telephone Number	:	248-550-0333

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	01/09/2017

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