Provider Demographics
NPI:1467276592
Name:RESILIENCY & RECOVERY, LLC
Entity type:Organization
Organization Name:RESILIENCY & RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADDICTION SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLTER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, IADC, PCDGC
Authorized Official - Phone:402-200-3808
Mailing Address - Street 1:108 N 49TH ST STE B103
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3172
Mailing Address - Country:US
Mailing Address - Phone:402-200-3808
Mailing Address - Fax:
Practice Address - Street 1:108 N 49TH ST STE B103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3172
Practice Address - Country:US
Practice Address - Phone:402-200-3808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty