Provider Demographics
NPI:1134739469
Name:STRIVE BEHAVIORAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:STRIVE BEHAVIORAL SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:NICHOL
Authorized Official - Last Name:FLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:920-209-3166
Mailing Address - Street 1:1542 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-3842
Mailing Address - Country:US
Mailing Address - Phone:920-209-3166
Mailing Address - Fax:
Practice Address - Street 1:1542 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-3842
Practice Address - Country:US
Practice Address - Phone:920-209-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-02
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty