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General NPI Number Information
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NPI Number | 1770288094
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Entity Type | Organization
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Legal Business Name | RESILIENT ASSISTANT WELLNESS CARE LLC
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 1201 W PEACHTREE ST NW STE 2611
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City | ATLANTA
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State | GA
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Zip | 30309-3499
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Country | US
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Telephone | 470-202-4694
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Fax | 855-866-0007
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Provider Business Mailing Address
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Address Line | 1201 W PEACHTREE ST NW STE 2611
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City | ATLANTA
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State | GA
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Zip | 30309-3499
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Country | US
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Telephone | 470-202-4694
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Fax | 855-866-0007
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. MONIQUE L AGUIRRE
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Credential |
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Telephone | 470-202-4694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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