Provider Demographics
NPI:1316705551
Name:MESA DEVELOPMENTAL SERVICES DBA STRIVE
Entity type:Organization
Organization Name:MESA DEVELOPMENTAL SERVICES DBA STRIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:BERGQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:970-256-8603
Mailing Address - Street 1:790 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6126
Mailing Address - Country:US
Mailing Address - Phone:970-256-8637
Mailing Address - Fax:
Practice Address - Street 1:790 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6126
Practice Address - Country:US
Practice Address - Phone:970-256-8637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MESA DEVELOPMENTAL SERVICES DBA STRIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty