Provider Demographics
NPI:1225646011
Name:SUNFLOWER BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:SUNFLOWER BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:REALYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILGENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-778-5182
Mailing Address - Street 1:1473 19 RD
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-9695
Mailing Address - Country:US
Mailing Address - Phone:970-778-5182
Mailing Address - Fax:
Practice Address - Street 1:655 N 12TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3343
Practice Address - Country:US
Practice Address - Phone:970-639-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty