Provider Demographics
NPI:1003276262
Name:RESUSCITATE INC.
Entity Type:Organization
Organization Name:RESUSCITATE INC.
Other - Org Name:FIRE FORGED RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-325-3934
Mailing Address - Street 1:PO BOX 25976
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33320-5976
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8245 NW 36TH ST
Practice Address - Street 2:UNIT 3
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6601
Practice Address - Country:US
Practice Address - Phone:855-968-7754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health