Provider Demographics
NPI:1740729094
Name:RESURGENCE HEALTH SYSTEMS
Entity type:Organization
Organization Name:RESURGENCE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-488-3300
Mailing Address - Street 1:1600 N CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2425
Mailing Address - Country:US
Mailing Address - Phone:443-488-3300
Mailing Address - Fax:
Practice Address - Street 1:1600 N CHESTER ST
Practice Address - Street 2:1600A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-2425
Practice Address - Country:US
Practice Address - Phone:443-488-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6244251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health