Sullivan Mental Health Services LLC
NPI #1003101577 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1003101577
- Entity Type
- Organization
- Organization Name
- Sullivan Mental Health Services LLC
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Jun 13, 2011
- Last Updated
- Nov 30, 2011
Practice Location
- Address
- 660 S WOODRUFF AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83401-5299
- Phone
- (208) 523-1558
Authorized Official
- Name
- MRS. JESSIE ELAINE SULLIVAN, LCPC LMFT
- Title
- OWNER/THERAPIST
- Phone
- (208) 523-1558
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