Provider Demographics
NPI:1043066582
Name:RESILIENT1 HEALTHCARE LLC
Entity type:Organization
Organization Name:RESILIENT1 HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALVONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-729-5687
Mailing Address - Street 1:1510 BATEAU LNDG
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-6603
Mailing Address - Country:US
Mailing Address - Phone:757-729-5687
Mailing Address - Fax:
Practice Address - Street 1:3276 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3203
Practice Address - Country:US
Practice Address - Phone:757-729-5687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health