Provider Demographics
NPI:1508633553
Name:FUNNER MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:FUNNER MENTAL HEALTH, LLC
Other - Org Name:SILVER RAIN HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:937-234-7789
Mailing Address - Street 1:4720 STRATHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-4662
Mailing Address - Country:US
Mailing Address - Phone:937-234-7789
Mailing Address - Fax:937-442-5574
Practice Address - Street 1:4720 STRATHAVEN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-4662
Practice Address - Country:US
Practice Address - Phone:937-305-2538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty