Provider Demographics
NPI:1992256945
Name:SUNNYHILL, INC.
Entity type:Organization
Organization Name:SUNNYHILL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF CLIENT SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WILLIS
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:III
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:314-845-3900
Mailing Address - Street 1:11140 S TOWNE SQ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7830
Mailing Address - Country:US
Mailing Address - Phone:314-845-3900
Mailing Address - Fax:314-845-3901
Practice Address - Street 1:11140 S TOWNE SQ
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7830
Practice Address - Country:US
Practice Address - Phone:314-845-3900
Practice Address - Fax:314-845-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011008097251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health