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General NPI Number Information
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NPI Number | 1073090049
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Entity Type | Organization
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Legal Business Name | RESILIENCE MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 2820 E US HIGHWAY 34 STE 2
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City | GRAND ISLAND
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State | NE
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Zip | 68801-9734
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Country | US
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Telephone | 308-380-5560
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 E US HIGHWAY 34 STE 2
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City | GRAND ISLAND
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State | NE
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Zip | 68801-9734
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Country | US
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Telephone | 308-380-5560
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARK W HARVEY
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Credential | APRN
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Telephone | 308-380-5560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 111016
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License Number State | NE
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