Organization
SULLIVAN DEVELOPMENT AND ACTIVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANITA SULLIVAN (EXECUTIVE DIRECTOR)
(936) 521-1700
Entity
Organization
Contact information
Practice address
15710 BOND LN, CONROE, TX 77303-4183
(936) 521-1700
(855) 693-4662
Mailing address
13985 BROKEN ARROW DR, WILLIS, TX 77378-4323
(936) 521-1700
(855) 693-4662
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
385HR2050X
Respite Care Camp
—
—
Other
Enumeration date
05/29/2016
Last updated
05/30/2016
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