Provider Demographics
NPI:1750774147
Name:RESILIENCE FOUNDATION OF DELAWARE, LLC
Entity type:Organization
Organization Name:RESILIENCE FOUNDATION OF DELAWARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDDIESHA
Authorized Official - Middle Name:JANEAN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:302-359-5116
Mailing Address - Street 1:177 ROLLIN CT
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-7664
Mailing Address - Country:US
Mailing Address - Phone:302-359-5116
Mailing Address - Fax:302-697-2254
Practice Address - Street 1:177 ROLLIN CT
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-7664
Practice Address - Country:US
Practice Address - Phone:302-359-5116
Practice Address - Fax:302-697-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management