Provider Demographics
NPI:1497377469
Name:RAISING RESILIENCE HOLISTIC MENTAL WELLNESS INC
Entity Type:Organization
Organization Name:RAISING RESILIENCE HOLISTIC MENTAL WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVARA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REARDON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-651-0604
Mailing Address - Street 1:500 N GOVERNMENT WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2976
Mailing Address - Country:US
Mailing Address - Phone:208-273-9147
Mailing Address - Fax:208-930-1811
Practice Address - Street 1:500 N GOVERNMENT WAY STE 300
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2976
Practice Address - Country:US
Practice Address - Phone:208-273-9147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty