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General NPI Number Information
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NPI Number | 1225646011
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Entity Type | Organization
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Legal Business Name | SUNFLOWER BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 655 N 12TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-3343
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Country | US
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Telephone | 970-639-0830
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Fax |
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Provider Business Mailing Address
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Address Line | 1473 19 RD
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City | FRUITA
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State | CO
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Zip | 81521-9695
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Country | US
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Telephone | 970-778-5182
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Fax |
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Authorized Official
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Title or Position | RN
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Name | REALYNN HILGENFELD
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Credential |
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Telephone | 970-778-5182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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