Healthcare Provider Details

I. General information

NPI: 1144144460
Provider Name (Legal Business Name): RESOLUTE MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 S LEWIS AVE STE 100
TULSA OK
74105-5178
US

IV. Provider business mailing address

4880 S LEWIS AVE STE 100
TULSA OK
74105-5178
US

V. Phone/Fax

Practice location:
  • Phone: 918-409-2712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY RUSIEWICZ
Title or Position: MEMBER
Credential:
Phone: 918-409-2712