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General NPI Number Information
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NPI Number | 1861202889
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Entity Type | Organization
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Legal Business Name | RESILIENT DIGNITY RECOVERY COMMUNITY CO-OP INC
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 1333 N 24TH ST APT 214
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City | PHOENIX
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State | AZ
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Zip | 85008-4674
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Country | US
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Telephone | 602-757-6346
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Fax |
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Provider Business Mailing Address
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Address Line | 220 N 12TH ST UNIT 248
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City | PHOENIX
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State | AZ
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Zip | 85034-1385
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Country | US
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Telephone | 602-757-6346
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARIA PETRARU
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Credential |
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Telephone | 602-757-6346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 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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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health 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 | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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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 #8
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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