Provider Demographics
NPI:1770288094
Name:RESILIENT ASSISTANT WELLNESS CARE LLC
Entity type:Organization
Organization Name:RESILIENT ASSISTANT WELLNESS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:L
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-202-4694
Mailing Address - Street 1:1201 W PEACHTREE ST NW STE 2611
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3499
Mailing Address - Country:US
Mailing Address - Phone:470-202-4694
Mailing Address - Fax:855-866-0007
Practice Address - Street 1:1201 W PEACHTREE ST NW STE 2611
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3499
Practice Address - Country:US
Practice Address - Phone:470-202-4694
Practice Address - Fax:855-866-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No251G00000XAgenciesHospice Care, Community Based
No251K00000XAgenciesPublic Health or Welfare
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization