Provider Demographics
NPI:1578319224
Name:RESILIENT MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:RESILIENT MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOCIAL WORKER CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ANNEST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-420-0880
Mailing Address - Street 1:17942 MOUNTAIN SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-5114
Mailing Address - Country:US
Mailing Address - Phone:208-420-0880
Mailing Address - Fax:
Practice Address - Street 1:17942 MOUNTAIN SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-5114
Practice Address - Country:US
Practice Address - Phone:208-420-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty