Healthcare Provider Details

I. General information

NPI: 1285150896
Provider Name (Legal Business Name): RESILIENT HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3271 E QUEEN CREEK RD STE 101
GILBERT AZ
85297-8511
US

IV. Provider business mailing address

2255 W NORTHERN AVE STE B100
PHOENIX AZ
85021-4936
US

V. Phone/Fax

Practice location:
  • Phone: 602-995-1767
  • Fax: 602-995-1863
Mailing address:
  • Phone: 602-995-1767
  • Fax: 602-995-1863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberOTC8445
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY QUIROS
Title or Position: COO
Credential:
Phone: 602-995-1767