Healthcare Provider Details

I. General information

NPI: 1265228811
Provider Name (Legal Business Name): RESILIENCE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 WAKE FOREST RD # 349
RALEIGH NC
27609-0010
US

IV. Provider business mailing address

4030 WAKE FOREST RD # 349
RALEIGH NC
27609-0010
US

V. Phone/Fax

Practice location:
  • Phone: 919-673-4869
  • Fax:
Mailing address:
  • Phone: 919-673-4869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: BUNN COMPANIES
Title or Position: OWNER
Credential:
Phone: 919-673-4869