Provider Demographics
NPI:1073090049
Name:RESILIENCE MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:RESILIENCE MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:308-380-5560
Mailing Address - Street 1:2820 E US HIGHWAY 34 STE 2
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-9734
Mailing Address - Country:US
Mailing Address - Phone:308-380-5560
Mailing Address - Fax:
Practice Address - Street 1:2820 E US HIGHWAY 34 STE 2
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-9734
Practice Address - Country:US
Practice Address - Phone:308-380-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111016363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty