| Resilient Mental Health Agency Llc | |
|
249 Cross Current Ln Raleigh NC 27610-1521 | |
| (919) 395-0142 | |
| (919) 301-8704 |
| Full Name | Resilient Mental Health Agency Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 249 Cross Current Ln, Raleigh, North Carolina |
| Authorized Official Name and Position | Tamuno George (CEO) |
| Authorized Official Contact | 9193950142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilient Mental Health Agency Llc 249 Cross Current Ln Raleigh NC 27610-1521 Ph: (919) 395-0142 | Resilient Mental Health Agency Llc 249 Cross Current Ln Raleigh NC 27610-1521 Ph: (919) 395-0142 |
| NPI Number | 1841757945 |
|---|---|
| Provider Enumeration Date | 02/25/2019 |
| Last Update Date | 12/19/2023 |
| Certification Date | 12/19/2023 |
| Medicare PECOS PAC ID | 6406243658 |
|---|---|
| Medicare Enrollment ID | O20220419000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841757945 | NPI | - | NPPES |
| Provider Name | Abby Rae Carlquist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962834168 PECOS PAC ID: 4880986520 Enrollment ID: I20160715001988 |
| Provider Name | Sherelle Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396128252 PECOS PAC ID: 3971990128 Enrollment ID: I20220419000288 |
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