Provider Demographics
NPI:1982945283
Name:RESILIENCY INTEGRATED HEALTHCARE SERVICES
Entity type:Organization
Organization Name:RESILIENCY INTEGRATED HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:EKANEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-414-7845
Mailing Address - Street 1:112 E 3RD STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ELOY
Mailing Address - State:AZ
Mailing Address - Zip Code:85131
Mailing Address - Country:US
Mailing Address - Phone:520-414-7845
Mailing Address - Fax:
Practice Address - Street 1:112 E 3RD STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:ELOY
Practice Address - State:AZ
Practice Address - Zip Code:85131
Practice Address - Country:US
Practice Address - Phone:520-414-7845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness