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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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