Resilia Neurotherapy Services, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

22494 Issued in CO

Legal business name

RESILIA NEUROTHERAPY SERVICES, LLC

Practice address

503 Remington St Ste 104
Fort Collins, CO 80524-3089

Phone

(970) 530-0135

Fax

(970) 315-0386

NPI assigned

May 26, 2010

Organization subpart

Yes

Parent organization

RESILIA, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Michaele Dawn Johnson, LCSW, MBA

Title

Executive Director

Phone

(970) 350-0135

Specialties & licenses 1

Addresses

Part of

Resilia LLC

Locations

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1235458597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 REMINGTON ST STE 104",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243089",
            "telephone_number": "970-530-0135",
            "fax_number": "970-315-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 REMINGTON ST STE 104",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243089",
            "telephone_number": "970-530-0135",
            "fax_number": "970-315-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIA NEUROTHERAPY SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RESILIA, LLC",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHAELE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "970-350-0135",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, MBA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CO",
            "license": "22494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Medical Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.