Healthcare Provider Details

I. General information

NPI: 1255195475
Provider Name (Legal Business Name): TROY RESILIENCE PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 09/08/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S BRUNDIDGE ST
TROY AL
36081-3331
US

IV. Provider business mailing address

401 S BRUNDIDGE ST
TROY AL
36081-3331
US

V. Phone/Fax

Practice location:
  • Phone: 334-770-0928
  • Fax:
Mailing address:
  • Phone: 334-770-0928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH N DAWSON
Title or Position: PRESIDENT
Credential: MD
Phone: 662-577-9876