Provider Demographics
NPI:1942922190
Name:RESOLUTION NATURAL-WELLNESS & CONCIERGE SERVICE, LLC
Entity Type:Organization
Organization Name:RESOLUTION NATURAL-WELLNESS & CONCIERGE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TEEISA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:678-774-9156
Mailing Address - Street 1:1545 N EXPRESSWAY STE 334
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-1746
Mailing Address - Country:US
Mailing Address - Phone:678-774-9156
Mailing Address - Fax:
Practice Address - Street 1:1313 N CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-1829
Practice Address - Country:US
Practice Address - Phone:678-774-9156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty