Provider Demographics
NPI:1285814020
Name:STRIVE JOINT & HEALTH CENTER P.C.
Entity Type:Organization
Organization Name:STRIVE JOINT & HEALTH CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCDADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-569-2000
Mailing Address - Street 1:1405 BALMORAL DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-1442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26771 W 12 MILE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1539
Practice Address - Country:US
Practice Address - Phone:248-569-2000
Practice Address - Fax:248-569-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074905208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI250F342720OtherBCBSM GROUP NUMBER
MIH04423Medicare UPIN
MI0P50670Medicare PIN