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General NPI Number Information
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NPI Number | 1578319224
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Entity Type | Organization
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Legal Business Name | RESILIENT MENTAL HEALTH LLC
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 17942 MOUNTAIN SPRINGS AVE
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City | NAMPA
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State | ID
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Zip | 83687-5114
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Country | US
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Telephone | 208-420-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 17942 MOUNTAIN SPRINGS AVE
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City | NAMPA
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State | ID
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Zip | 83687-5114
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Country | US
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Telephone | 208-420-0880
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Fax |
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Authorized Official
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Title or Position | OWNER/SOCIAL WORKER CLINICIAN
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Name | MR. STEPHEN JAMES ANNEST
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Credential | LCSW
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Telephone | 208-420-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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