Provider Demographics
NPI:1487454294
Name:RESURGENCE RESIDENTIAL SOLUTIONS LLC
Entity type:Organization
Organization Name:RESURGENCE RESIDENTIAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR DIRECTOR DESIGNEE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-868-7810
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-0146
Mailing Address - Country:US
Mailing Address - Phone:567-868-7810
Mailing Address - Fax:
Practice Address - Street 1:1720 INDIAN WOOD CIR STE I
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-4041
Practice Address - Country:US
Practice Address - Phone:567-868-7810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEHOVAH NISSI HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities