Provider Demographics
NPI:1578037271
Name:RESILIENCE REHABILITATION, LLC
Entity type:Organization
Organization Name:RESILIENCE REHABILITATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HUA MA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDINGLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-772-5191
Mailing Address - Street 1:25207 PARKCREST DR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25207 PARKCREST DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5950
Practice Address - Country:US
Practice Address - Phone:562-841-2537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility