Healthcare Provider Details

I. General information

NPI: 1972308450
Provider Name (Legal Business Name): RESOLUTIONS HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 W PARK PL STE 222
COEUR D ALENE ID
83814-2784
US

IV. Provider business mailing address

285 W PRAIRIE SHOPPING CTR # 157
HAYDEN ID
83835-9855
US

V. Phone/Fax

Practice location:
  • Phone: 469-915-4211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AL BERRY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 469-915-4211