Provider Demographics
NPI:1740712504
Name:THE RESILIENCY CENTER INC
Entity type:Organization
Organization Name:THE RESILIENCY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:BOLINGER
Authorized Official - Last Name:RAABE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LCPC
Authorized Official - Phone:217-679-0356
Mailing Address - Street 1:3233 MATHERS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-7936
Mailing Address - Country:US
Mailing Address - Phone:217-679-0356
Mailing Address - Fax:217-670-1688
Practice Address - Street 1:3233 MATHERS RD
Practice Address - Street 2:SUITE C
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-7936
Practice Address - Country:US
Practice Address - Phone:217-679-0356
Practice Address - Fax:217-670-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180001720251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health