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General NPI Number Information
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NPI Number | 1093370561
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Entity Type | Organization
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Legal Business Name | RESILIENCY OUTREACH COMMUNITY SERVICES, INC
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 15970 S SHIBELL CIRCLE UNIT A
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City | ARIZONA CITY
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State | AZ
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Zip | 85123
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Country | US
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Telephone | 520-709-4645
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3699
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City | ARIZONA CITY
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State | AZ
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Zip | 85123-2459
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Country | US
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Telephone | 520-709-4645
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RENEE BURTON
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Credential |
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Telephone | 520-709-4645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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