Organization
KAVANA CARE UT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL TENNENBAUM (SOLE MBR)
(516) 371-9500
Entity
Organization
Contact information
Practice address
2825 E COTTONWOOD PKWY, COTTONWOOD HEIGHTS, UT 84121-7055
(163) 719-5005
Mailing address
2825 E COTTONWOOD PKWY STE 500, COTTONWOOD HEIGHTS, UT 84121-7060
(732) 339-7360
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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