Provider Demographics
NPI:1548017650
Name:SUNFLOWER WELLNESS SERVICES
Entity type:Organization
Organization Name:SUNFLOWER WELLNESS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-801-4145
Mailing Address - Street 1:2191 ARROYO RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1076
Mailing Address - Country:US
Mailing Address - Phone:541-801-4145
Mailing Address - Fax:541-237-6288
Practice Address - Street 1:333 NW 35TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4908
Practice Address - Country:US
Practice Address - Phone:541-801-4145
Practice Address - Fax:541-237-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty