Healthcare Provider Details

I. General information

NPI: 1528402773
Provider Name (Legal Business Name): THE RESOLUTION GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 N IDAHO RD 10
APACHE JUNCTION AZ
85119-4002
US

IV. Provider business mailing address

623 W SOUTHERN AVE 7
MESA AZ
85210-5029
US

V. Phone/Fax

Practice location:
  • Phone: 480-962-9288
  • Fax: 480-962-1293
Mailing address:
  • Phone: 480-962-9288
  • Fax: 480-962-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC2079
License Number StateAZ

VIII. Authorized Official

Name: DENISE M THOMPSON
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 480-962-9288