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Organization
CREATIVE POTENTIAL LLC
Active
Organization
CREATIVE POTENTIAL LLC
Active
Other names
Creative Potential
Organization subpart
No
Provider details
NPI number
Authorized official
SIERRA R DAVIS MS (OWNER)
(860) 848-0514
Entity
Organization
Contact information
Practice address
912 NORWICH NEW LONDON TPKE STE 5, UNCASVILLE, CT 06382-1908
(860) 848-0514
(860) 848-0523
Mailing address
912 NORWICH NEW LONDON TPKE STE 5, UNCASVILLE, CT 06382-1908
(860) 848-0514
(860) 848-0523
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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