Provider Demographics
NPI:1215749163
Name:STRONGBRIDGE INTEGRATED SOLUTIONS LLC
Entity type:Organization
Organization Name:STRONGBRIDGE INTEGRATED SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:OLUGBENGA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBAJUWONLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-541-4817
Mailing Address - Street 1:4442 AVERY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5488
Mailing Address - Country:US
Mailing Address - Phone:702-541-4817
Mailing Address - Fax:
Practice Address - Street 1:4442 AVERY PARK AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5488
Practice Address - Country:US
Practice Address - Phone:702-541-4817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRONGBRIDGE INTEGRATED SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty