1265216436 NPI number — RESILIENCY RISING LLC

Table of content: (NPI 1265216436)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265216436 NPI number — RESILIENCY RISING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESILIENCY RISING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265216436
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 426
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAILEY
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83333-0400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-481-4639
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 SPRUCE AVE. N.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KETCHUM
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-481-4639
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2023

Additional Information

Authorized Official

Authorized Official Last Name:
STRAND
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
208-481-4639

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 39026 . This is a "UNITED MEDICAL RESOURCES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 93029 . This is a "PACIFICSOURCE HEALTH PLANS" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: IDBLC . This is a "BLUE CROSS BLUE SHIELD OF IDAHO" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: NCBLS . This is a "BLUE CROSS BLUE SHIELD OF NORTH CAROLINA" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: RGBLS . This is a "REGENCE BLUE SHIELD OF WASHINGTON" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: IDBLS . This is a "BLUE SHIELD OF IDAHO" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: RGA01 . This is a "REGENCE GROUP ADMINISTRATORS" identifier . This identifiers is of the category "OTHER".
  • Identifier: UH107 . This is a "SELECTHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 39026 . This is a "UMR" identifier . This identifiers is of the category "OTHER".
  • Identifier: SX155 . This is a "MOUNTAIN HEALTH CO-OP" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 84076 . This is a "SINCLAIR HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: IDBLC . This is a "BLUE CROSS OF IDAHO" identifier . This identifiers is of the category "OTHER".
  • Identifier: WABLC . This is a "WASHINGTON STATE PREMERA BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: SX155 . This is a "UNIVERSITY OF UTAH HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: SX155 . This is a "UNIVERSITY OF UTAH" identifier . This identifiers is of the category "OTHER".
  • Identifier: BC001 . This is a "ANTHEM BLUE CROSS OF CALIFORNIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: UH107 . This is a "SELECT HEALTH IHC INTERMOUNTAIN HEALTH" identifier . This identifiers is of the category "OTHER".




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