Provider Demographics
NPI:1609518349
Name:RESILIO MENTAL HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:RESILIO MENTAL HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:610-202-9142
Mailing Address - Street 1:103 GARRIS RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3115
Mailing Address - Country:US
Mailing Address - Phone:484-657-4802
Mailing Address - Fax:484-364-4601
Practice Address - Street 1:103 GARRIS RD
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3115
Practice Address - Country:US
Practice Address - Phone:484-657-4802
Practice Address - Fax:484-364-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty