Provider Demographics
NPI:1871197152
Name:STRIDE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:STRIDE HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULLAHI
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-404-6892
Mailing Address - Street 1:3031 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2401
Mailing Address - Country:US
Mailing Address - Phone:612-404-6892
Mailing Address - Fax:612-333-0308
Practice Address - Street 1:3031 2ND AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2401
Practice Address - Country:US
Practice Address - Phone:612-404-6892
Practice Address - Fax:612-333-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility