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Organization

RESILIA. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. IVETTE LOPEZ BLEDSOE LCSW (THERAPIST/OWNER)
(706) 395-3091
Entity
Organization

Contact information

Practice address
1 HUNTINGTON RD STE 205, ATHENS, GA 30606-7206
(706) 395-3091
(970) 315-3560
Mailing address
1341 ARIZONA BND, WATKINSVILLE, GA 30677-7774
(678) 726-0211
(970) 315-3560

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
627
CO
251S00000X
Community/Behavioral Health Agency
Primary
CSW005801
GA

Other

Enumeration date
07/10/2007
Last updated
10/11/2018
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