MEDICARE: RESOLUTE ACQUISITION CORPORATION

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
1	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1497573356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOLUTE ACQUISITION CORPORATION

Provider Business Mailing Address
First Line	:	6100 TOWER CIR STE 1000
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-1509
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 N TIBBS AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-4064
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT & SECRETARY
Name	:	BRIAN PHILLIP FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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