| Sullivan Mental Health Services Llc | |
|
660 S Woodruff Ave Idaho Falls ID 83401-5299 | |
| (208) 523-1558 | |
| (208) 529-4788 |
| Full Name | Sullivan Mental Health Services Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 660 S Woodruff Ave, Idaho Falls, Idaho |
| Authorized Official Name and Position | Jessie Elaine Sullivan (OWNER/THERAPIST) |
| Authorized Official Contact | 2085231558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan Mental Health Services Llc 660 S Woodruff Ave Idaho Falls ID 83401-5299 Ph: (208) 523-1558 | Sullivan Mental Health Services Llc 660 S Woodruff Ave Idaho Falls ID 83401-5299 Ph: (208) 523-1558 |
| NPI Number | 1003101577 |
|---|---|
| Provider Enumeration Date | 06/13/2011 |
| Last Update Date | 11/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003101577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (Idaho) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (Idaho) | Secondary |
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