Sullivan Development and Activity Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SULLIVAN DEVELOPMENT AND ACTIVITY CENTER, INC.

Practice address

15710 Bond LN
Conroe, TX 77303-4183

Phone

(936) 521-1700

Fax

(855) 693-4662

NPI assigned

May 29, 2016

Last updated

May 16, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tanita SullivanNPI 1659671147

Title

Executive Director

Phone

(936) 521-1700

Specialties & licenses 5

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tanita Shanta Sullivan

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Willis, TX
  • NPI 1659671147
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778889600000",
    "number": "1316395585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13985 BROKEN ARROW DR",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773784323",
            "telephone_number": "832-549-1364",
            "fax_number": "855-693-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15710 BOND LN",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773034183",
            "telephone_number": "936-521-1700",
            "fax_number": "855-693-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN DEVELOPMENT AND ACTIVITY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-29",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TANITA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "936-521-1700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jane Sturman, RN
• Ryan Su
• William A Suber, LPC, LCDC, ADC III
• Aishah Jehad Suleiman, MD
• Lauri Catherine Sulewski, LPC-A
• Mary Sullivan Gilbert, LPC
• Sullivan Help Center Corporation
• Sarib Mohammad Sultan
• Cordigan Summers, DO
• Celia Holgado Sumodobila

• Community/Behavioral Health Agency in Conroe, TX
• Providers in Conroe, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.