Provider Demographics
NPI:1982652798
Name:RESOLUTIONS HEALTH ALLIANCE, PA
Entity Type:Organization
Organization Name:RESOLUTIONS HEALTH ALLIANCE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMHC
Authorized Official - Phone:386-754-9005
Mailing Address - Street 1:1688 EAST BAYA AVE.
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025
Mailing Address - Country:US
Mailing Address - Phone:386-754-9005
Mailing Address - Fax:386-754-9017
Practice Address - Street 1:1688 EAST BAYA AVE.
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025
Practice Address - Country:US
Practice Address - Phone:386-754-9005
Practice Address - Fax:386-754-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty