Individual provider · Type 1 NPI

Nicole Marie Sullivan

Emotionally Disturbed Childrens' Residential Treatment Facility · Grass Valley, CA

NPI number 1669802732 Active

Practice location

714 W Main Street
Grass Valley, CA 95945

Call (530) 477-9800 Map

Fax (530) 477-9803

Mailing address

714 W. Main St.
Grass Valley, CA 95945

Specialties and licenses

TaxonomyCodeLicense
Emotionally Disturbed Childrens' Residential Treatment Facility Primary 322D00000XNone listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1669802732

Nicole Marie Sullivan's National Provider Identifier is 1669802732, issued on Nov 26, 2013. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Grass Valley, CA. The record was last updated on Nov 26, 2013.