NPI Index

TANITA SULLIVAN

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Active Individual
NPI: 1659671147

Practice Address

13985 BROKEN ARROW DR
Willis, TX 77378

Phone: (936) 856-6136

Specialties

Specialty Code Primary License
Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X Yes -
Residential Treatment Facility, Physical Disabilities 320700000X No -
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X No -
Substance Abuse Rehabilitation Facility 324500000X No -

Frequently Asked Questions

NPI 1659671147 is the National Provider Identifier for TANITA SULLIVAN, a Residential Treatment Facility, Intellectual and/or Developmental Disabilities provider located in Willis, TX. This NPI was enumerated on October 29, 2010.
TANITA SULLIVAN practices at 13985 BROKEN ARROW DR, Willis, TX 77378.

Quick Facts

NPI
1659671147
Type
Individual
Enumerated
Oct 29, 2010
Last Updated
Oct 29, 2010

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