Provider Demographics
NPI:1154104875
Name:RESILIENCE MENTAL HEALTH,LLC
Entity type:Organization
Organization Name:RESILIENCE MENTAL HEALTH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-280-5830
Mailing Address - Street 1:79 HIGHWAY 286
Mailing Address - Street 2:UNIT B
Mailing Address - City:ETON
Mailing Address - State:GA
Mailing Address - Zip Code:30705
Mailing Address - Country:US
Mailing Address - Phone:706-971-3757
Mailing Address - Fax:
Practice Address - Street 1:79 HIGHWAY 286
Practice Address - Street 2:UNIT B
Practice Address - City:ETON
Practice Address - State:GA
Practice Address - Zip Code:30705
Practice Address - Country:US
Practice Address - Phone:706-971-3757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty