Provider Demographics
NPI:1972101970
Name:RESOLUTION BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:RESOLUTION BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUDOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-641-2414
Mailing Address - Street 1:3575 MACON RD STE 8
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-8226
Mailing Address - Country:US
Mailing Address - Phone:706-641-2414
Mailing Address - Fax:706-641-2408
Practice Address - Street 1:3575 MACON RD STE 8
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-8226
Practice Address - Country:US
Practice Address - Phone:706-641-2414
Practice Address - Fax:706-641-2408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health