Provider Demographics
NPI:1497235576
Name:SATURN SUPPORTS LLC
Entity Type:Organization
Organization Name:SATURN SUPPORTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-344-9674
Mailing Address - Street 1:3228 SW BEAVERTON HILLSDALE HWY APT 23
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-1193
Mailing Address - Country:US
Mailing Address - Phone:971-344-9674
Mailing Address - Fax:
Practice Address - Street 1:3228 SW BEAVERTON HILLSDALE HWY APT 23
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1193
Practice Address - Country:US
Practice Address - Phone:971-344-9674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDZ1279251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health