Organization
CREATIVE BEHAVIORAL CONNECTIONS UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY GROSSA (CFO)
(702) 901-5200
Entity
Organization
Contact information
Practice address
1108 E SOUTH UNION AVE, MIDVALE, UT 84047-2904
(702) 901-5200
Mailing address
5803 W CRAIG RD STE 105, LAS VEGAS, NV 89130-2537
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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