HENRY EARL SULLIVAN

GRANTS PASS, OR
NPI1174986632
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  12-03-48)
Enumeration Date2016-04-01
Last Update Date2016-04-01
Business Address
-- HENRY EARL SULLIVAN CADC 1
510 NW 4TH ST
GRANTS PASS, OR 97526-2078
Phone number: 541-474-5189
Mailing Address
-- HENRY EARL SULLIVAN CADC 1
510 NW 4TH ST
GRANTS PASS, OR 97526-2078
Phone number: 541-474-5189
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