Healthcare Provider Details

I. General information

NPI: 1962062950
Provider Name (Legal Business Name): RESILIENCE FAMILY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 DENNIS ST TRLR 82
EDMOND OK
73003-5737
US

IV. Provider business mailing address

301 DENNIS ST TRLR 82
EDMOND OK
73003-5737
US

V. Phone/Fax

Practice location:
  • Phone: 405-509-8845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: ANGELA TOWNSEND
Title or Position: CEO/OWNER
Credential:
Phone: 405-509-8845