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General NPI Number Information
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NPI Number | 1841970282
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Entity Type | Organization
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Legal Business Name | RESILIENT BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 2911 DIXWELL AVE STE B-5
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City | HAMDEN
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State | CT
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Zip | 06518-3130
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Country | US
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Telephone | 203-903-8423
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Fax |
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Provider Business Mailing Address
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Address Line | 397 EASTERN ST APT F
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City | NEW HAVEN
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State | CT
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Zip | 06513-2369
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Country | US
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Telephone | 203-668-8203
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE E TIRADO
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Credential | LPC
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Telephone | 203-668-8203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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