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
1	251K00000X	Public Health or Welfare Agency	BH-977	AZ
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881680452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENT HEALTH, INC.

Provider Business Mailing Address
First Line	:	2255 W NORTHERN AVE
Second Line	:	SUITE B-100
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	:	2255 W NORTHERN AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4936
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	:	09/20/2005
Last Update Date	:	11/20/2024

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Directions to “RESILIENT HEALTH, INC. ” Practice Location

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