Provider Demographics
NPI:1093297368
Name:STRIVE HOME CARE LLC
Entity Type:Organization
Organization Name:STRIVE HOME CARE LLC
Other - Org Name:STRIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:STILL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:612-434-7039
Mailing Address - Street 1:7419 ABBOTT AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3529
Mailing Address - Country:US
Mailing Address - Phone:612-434-7039
Mailing Address - Fax:
Practice Address - Street 1:3300 COUNTY ROAD 10 STE 512D
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3068
Practice Address - Country:US
Practice Address - Phone:612-434-7039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)