Organization
RESILIENCY VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A DYKEN (EXECUTIVE DIRECTOR)
(209) 559-0802
Entity
Organization
Contact information
Practice address
13707 JENNY LIND ROAD, SONORA, CA 95370-9522
(209) 559-0802
Mailing address
PO BOX 523, SOULSBYVILLE, CA 95372-0523
(209) 559-0802
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/31/2023
Last updated
06/04/2025
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