Provider Demographics
NPI:1639803760
Name:STRIVE MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:STRIVE MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-207-9681
Mailing Address - Street 1:4529 W SANCTION RD
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-7623
Mailing Address - Country:US
Mailing Address - Phone:352-558-8054
Mailing Address - Fax:352-218-8485
Practice Address - Street 1:2440 N ESSEX AVE
Practice Address - Street 2:
Practice Address - City:CITRUS HILLS
Practice Address - State:FL
Practice Address - Zip Code:34442-5320
Practice Address - Country:US
Practice Address - Phone:352-558-8054
Practice Address - Fax:352-218-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty