Healthcare Provider Details

I. General information

NPI: 1245161678
Provider Name (Legal Business Name): CONNECTIONSPA MONTOGMERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 S 7TH AVE STE 105
PHOENIX AZ
85007-3913
US

IV. Provider business mailing address

1021 W 8TH AVE
KING OF PRUSSIA PA
19406-1323
US

V. Phone/Fax

Practice location:
  • Phone: 602-416-7647
  • Fax:
Mailing address:
  • Phone: 717-408-1353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHERYL BOYLE
Title or Position: DIRECTOR RCM
Credential:
Phone: 830-997-7367