Provider Demographics
NPI:1871545939
Name:RESILIENCE HEALTH CARE LLC
Entity type:Organization
Organization Name:RESILIENCE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WALLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-670-5596
Mailing Address - Street 1:8 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1882
Mailing Address - Country:US
Mailing Address - Phone:860-670-5596
Mailing Address - Fax:860-233-1967
Practice Address - Street 1:8 LOWELL RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1882
Practice Address - Country:US
Practice Address - Phone:860-670-5596
Practice Address - Fax:860-233-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031694261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health