Provider Demographics
NPI:1033556493
Name:THE RESILIENCY INSTITUTE, INC
Entity Type:Organization
Organization Name:THE RESILIENCY INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DOMENIC
Authorized Official - Last Name:CAPACHIONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-429-2596
Mailing Address - Street 1:4 SHACKLEFORD CV
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-9729
Mailing Address - Country:US
Mailing Address - Phone:912-450-9700
Mailing Address - Fax:
Practice Address - Street 1:706 G ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-6749
Practice Address - Country:US
Practice Address - Phone:912-450-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-25
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004074251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health