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NPI Code Detail

MEDICARE: RESILIENT HEALTH, INC.

MEDICARE: RESILIENT HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center
2251S00000XCommunity/Behavioral Health AgencyOTC8445AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OTC8445OTHERAZAZ LICENSE

General Provider Information

NPI Number : 1285150896
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESILIENT HEALTH, INC.
Provider Business Mailing Address
First Line : 2255 W NORTHERN AVE STE B100
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-4936
Country : US
Telephone Number : 602-995-1767
Fax Number : 602-995-1863
Provider Business Practice Location Address
First Line : 3271 E QUEEN CREEK RD STE 101
Second Line :
City : GILBERT
State : AZ
Zip : 85297-8511
Country : US
Telephone Number : 602-995-1767
Fax Number : 602-995-1863
Authorized Official
Title or Position : COO
Name : KIMBERLY QUIROS
Credential :
Telephone Number : 602-995-1767
Provider Enumeration Date : 08/15/2017
Last Update Date : 11/20/2024

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