Resilient Life Therapeutic Services LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

RESILIENT LIFE THERAPEUTIC SERVICES LLC

Practice address

89 E Edsel Ford Fwy Ste 200
Detroit, MI 48202-3742

Phone

(248) 943-1814

NPI assigned

Jul 7, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacqueline Maria Beavers, LMSW

Title

Sole Owner

Phone

(248) 943-1814

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1083285407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19300 APPOLINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 E EDSEL FORD FWY STE 200",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023742",
            "telephone_number": "248-943-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT LIFE THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "248-943-1814",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reroute Home Care Transportation LLC
• Leah Bethel Resh
• Residential Home Communities LLC
• Residential Wellness Group LLC
• Resilience Mental Health and Wellness
• Summar Reslan, PH.D.
• Responsible Hands Pain Managemet and Therapy Services Inc
• Rest Counseling Services
• Restful Retreat LLC
• Restoration Counseling Services LLC

• Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.