Provider Demographics
NPI:1821430471
Name:RAISING RESILIENCY, LLC
Entity Type:Organization
Organization Name:RAISING RESILIENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-510-0815
Mailing Address - Street 1:8715 W. UNION HILLS DR.
Mailing Address - Street 2:#111
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:623-328-9539
Practice Address - Street 1:8715 W. UNION HILLS DR.
Practice Address - Street 2:#111
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3031
Practice Address - Country:US
Practice Address - Phone:602-510-0815
Practice Address - Fax:623-328-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC#13546101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty