Provider Demographics
| NPI: | 1003770140 |
|---|---|
| Name: | RESILIENT REIMAGINE INC |
| Entity type: | Organization |
| Organization Name: | RESILIENT REIMAGINE INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | MANAGING PARTNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ANGELLA |
| Authorized Official - Middle Name: | B |
| Authorized Official - Last Name: | JULIUS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 301-237-4369 |
| Mailing Address - Street 1: | 14440 CHERRY LANE CT STE 114 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LAUREL |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 20707-4946 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 301-237-4369 |
| Mailing Address - Fax: | 302-719-0421 |
| Practice Address - Street 1: | 14440 CHERRY LANE CT STE 114 |
| Practice Address - Street 2: | |
| Practice Address - City: | LAUREL |
| Practice Address - State: | MD |
| Practice Address - Zip Code: | 20707-4946 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 301-237-4369 |
| Practice Address - Fax: | 302-719-0421 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-12-12 |
| Last Update Date: | 2025-12-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
| No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic | Group - Multi-Specialty |
| No | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation | Group - Multi-Specialty |
| No | 146N00000X | Emergency Medical Service Providers | Emergency Medical Technician, Basic | Group - Multi-Specialty | |
| No | 163WA0400X | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | Group - Multi-Specialty |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
