Provider Demographics
NPI:1326370008
Name:RESILIENCE REHAB & EDUCATIONAL SERVICES LLC
Entity type:Organization
Organization Name:RESILIENCE REHAB & EDUCATIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANG PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:727-320-4098
Mailing Address - Street 1:507 BRANTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-2905
Mailing Address - Country:US
Mailing Address - Phone:727-320-4098
Mailing Address - Fax:888-834-7415
Practice Address - Street 1:407 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6138
Practice Address - Country:US
Practice Address - Phone:813-681-4741
Practice Address - Fax:888-834-7415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8958261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech