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General NPI Number Information
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NPI Number | 1437928421
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC RESILIENCE LLC
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Dates
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Enumeration Date | 01/01/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 784 S CLEARWATER LOOP STE R
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City | POST FALLS
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State | ID
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Zip | 83854-9599
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Country | US
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Telephone | 208-508-2201
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Fax |
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Provider Business Mailing Address
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Address Line | 212 W IRONWOOD DR. #D P.O. BOX 156
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City | COEUR D'ALENE
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State | ID
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Zip | 83814-9599
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Country | US
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Telephone | 208-508-2201
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Fax | 409-217-3245
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Authorized Official
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Title or Position | CEO
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Name | MR. ZACHARY HARMAN
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Credential |
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Telephone | 208-508-2201
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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 |
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License Number State |
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