Provider Demographics
NPI:1750992079
Name:TRAUMA AND RESILIENCY RESOURCES, INC.
Entity type:Organization
Organization Name:TRAUMA AND RESILIENCY RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:USADI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCD
Authorized Official - Phone:917-509-5804
Mailing Address - Street 1:26 W 9TH ST APT 5E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8922
Mailing Address - Country:US
Mailing Address - Phone:855-877-4968
Mailing Address - Fax:
Practice Address - Street 1:WINSLOW THERAPEUTIC CENTER
Practice Address - Street 2:1433 NY-17A
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990
Practice Address - Country:US
Practice Address - Phone:845-986-6686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health