Provider Demographics
NPI:1831718790
Name:REZILIENT HOPE LLC
Entity type:Organization
Organization Name:REZILIENT HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-251-8000
Mailing Address - Street 1:1307 GULF STREAM CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-2819
Mailing Address - Country:US
Mailing Address - Phone:662-251-8000
Mailing Address - Fax:
Practice Address - Street 1:1307 GULF STREAM CIR APT 102
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-2819
Practice Address - Country:US
Practice Address - Phone:662-251-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty