Provider Demographics
NPI:1104246628
Name:RESOLUTIONS HEATLH ALLIANCE
Entity type:Organization
Organization Name:RESOLUTIONS HEATLH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMITIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-754-9005
Mailing Address - Street 1:492 W DUVAL ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-3899
Mailing Address - Country:US
Mailing Address - Phone:386-754-9005
Mailing Address - Fax:386-754-9011
Practice Address - Street 1:492 W DUVAL ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-3899
Practice Address - Country:US
Practice Address - Phone:386-754-9005
Practice Address - Fax:386-754-9011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESOLUTIONS HEALTH ALLIANCE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-23
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018892800Medicaid