Healthcare Provider Details

I. General information

NPI: 1912416504
Provider Name (Legal Business Name): RESILIENT CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 09/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24237 MAIN ST
NEWHALL CA
91321
US

IV. Provider business mailing address

19330 MORIAH LN
SANTA CLARITA CA
91350
US

V. Phone/Fax

Practice location:
  • Phone: 888-705-0053
  • Fax:
Mailing address:
  • Phone: 661-210-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MUSABBIR CHOWDHURY
Title or Position: CEO
Credential:
Phone: 661-210-9375