Provider Demographics
NPI:1356147706
Name:RESILIENT VET
Entity type:Organization
Organization Name:RESILIENT VET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZIMWASHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-939-9431
Mailing Address - Street 1:2238 POST OAK TRITT RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1612
Mailing Address - Country:US
Mailing Address - Phone:678-939-9431
Mailing Address - Fax:
Practice Address - Street 1:2238 POST OAK TRITT RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-1612
Practice Address - Country:US
Practice Address - Phone:678-939-9431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESILIENT VET
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty