Provider Demographics
NPI:1689075574
Name:RESILIENCE HOME CARE, LLC
Entity Type:Organization
Organization Name:RESILIENCE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-345-7720
Mailing Address - Street 1:2111 JEFFERSON DAVIS HWY APT 307N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-3127
Mailing Address - Country:US
Mailing Address - Phone:802-345-7720
Mailing Address - Fax:
Practice Address - Street 1:2111 JEFFERSON DAVIS HWY APT 307N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3127
Practice Address - Country:US
Practice Address - Phone:802-345-7720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health