Healthcare Provider Details

I. General information

NPI: 1609682020
Provider Name (Legal Business Name): VALIANT RESOURCE AND MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/10/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5532 BROOK RUN DRIVE
MEDINA OH
44256
US

IV. Provider business mailing address

4029 PEARL RD
MEDINA OH
44256-7647
US

V. Phone/Fax

Practice location:
  • Phone: 614-900-0111
  • Fax:
Mailing address:
  • Phone: 614-900-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGEL JAMES
Title or Position: CEO/ THERAPIST
Credential: DSW
Phone: 614-900-0111