Provider Demographics
NPI:1467266262
Name:RESILIENCE MED-PSYCH, LLC
Entity type:Organization
Organization Name:RESILIENCE MED-PSYCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:BRYANT
Authorized Official - Last Name:PARSON
Authorized Official - Suffix:IV
Authorized Official - Credentials:NP
Authorized Official - Phone:707-293-5849
Mailing Address - Street 1:11 IVORY GULL CRES
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23664-1553
Mailing Address - Country:US
Mailing Address - Phone:707-293-5849
Mailing Address - Fax:
Practice Address - Street 1:11 IVORY GULL CRES
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23664-1553
Practice Address - Country:US
Practice Address - Phone:707-293-5849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty