Provider Demographics
NPI:1700422938
Name:BUILDING RESILIENCY LLC
Entity Type:Organization
Organization Name:BUILDING RESILIENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVONNE
Authorized Official - Middle Name:JENIER
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHP-R
Authorized Official - Phone:757-768-1092
Mailing Address - Street 1:1400 SELMA LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1263
Mailing Address - Country:US
Mailing Address - Phone:757-768-1092
Mailing Address - Fax:
Practice Address - Street 1:7529 S FRANKLINS WAY
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-2360
Practice Address - Country:US
Practice Address - Phone:757-768-1092
Practice Address - Fax:804-258-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0892363216Medicaid