Resilience Anti-Aging & Internal Medicine Wellness Clinic Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

RESILIENCE ANTI-AGING & INTERNAL MEDICINE WELLNESS CLINIC INC

Practice address

25701 N Lakeland Blvd
Suite 300
Euclid, OH 44132-2450

Phone

(216) 261-6398

Fax

(440) 525-5564

NPI assigned

May 4, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Donavon Huff, MASTER TRAINER

Title

V.P.

Phone

(216) 261-3698

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1831576446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25701 N LAKELAND BLVD",
            "address_2": "SUITE 300",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441322450",
            "telephone_number": "216-261-6398",
            "fax_number": "440-525-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25701 N LAKELAND BLVD",
            "address_2": "SUITE 300",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441322450",
            "telephone_number": "216-261-6398",
            "fax_number": "440-525-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENCE ANTI-AGING & INTERNAL MEDICINE WELLNESS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "HUFF",
        "authorized_official_first_name": "DONAVON",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "216-261-3698",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER TRAINER"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Euclid, OH
• Providers in Euclid, OH by specialty
• Multi-Specialty Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.