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General NPI Number Information
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NPI Number | 1851039986
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Entity Type | Organization
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Legal Business Name | RESILIENT LIFE CENTER, LLC
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 7200 LAKE ELLENOR DR STE 123
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City | ORLANDO
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State | FL
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Zip | 32809-5787
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Country | US
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Telephone | 787-717-9127
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 LAKE ELLENOR DR STE 123
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City | ORLANDO
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State | FL
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Zip | 32809-5787
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Country | US
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Telephone | 787-717-9127
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER
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Name | ITZAURIMAR MONSERRATE
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Credential | MBA, CBHCM
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Telephone | 787-717-9127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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