Provider Demographics
NPI:1437928421
Name:PSYCHIATRIC RESILIENCE LLC
Entity type:Organization
Organization Name:PSYCHIATRIC RESILIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-508-2201
Mailing Address - Street 1:212 W IRONWOOD DR. #D
Mailing Address - Street 2:P.O. BOX 156
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-9599
Mailing Address - Country:US
Mailing Address - Phone:208-508-2201
Mailing Address - Fax:409-217-3245
Practice Address - Street 1:784 S CLEARWATER LOOP STE R
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9599
Practice Address - Country:US
Practice Address - Phone:208-508-2201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty