Provider Demographics
NPI:1437976032
Name:RESILIENT AGENCY
Entity type:Organization
Organization Name:RESILIENT AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:GUEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-768-7686
Mailing Address - Street 1:2429 RIVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-1134
Mailing Address - Country:US
Mailing Address - Phone:323-768-7686
Mailing Address - Fax:
Practice Address - Street 1:1925 W TEMPLE ST STE 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-4972
Practice Address - Country:US
Practice Address - Phone:213-322-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management