| Resilient Roots Behavioral Health Llc | |
|
1260 Sw Topeka Blvd Topeka KS 66612-1815 | |
| (785) 301-1537 | |
| (785) 203-8439 |
| Full Name | Resilient Roots Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1260 Sw Topeka Blvd, Topeka, Kansas |
| Authorized Official Name and Position | Garrett Delong (APRN) |
| Authorized Official Contact | 7853011537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilient Roots Behavioral Health Llc 1260 Sw Topeka Blvd Topeka KS 66612-1815 Ph: (785) 301-1537 | Resilient Roots Behavioral Health Llc 1260 Sw Topeka Blvd Topeka KS 66612-1815 Ph: (785) 301-1537 |
| NPI Number | 1902659121 |
|---|---|
| Provider Enumeration Date | 04/08/2024 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Medicare PECOS PAC ID | 8527501238 |
|---|---|
| Medicare Enrollment ID | O20240624000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902659121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Garrett Delong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376128132 PECOS PAC ID: 4385048974 Enrollment ID: I20210804000839 |
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