Healthcare Provider Details
I. General information
NPI: 1952141889
Provider Name (Legal Business Name): CONNECTIONSPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 S CAMERON ST STE 2
HARRISBURG PA
17104-2547
US
IV. Provider business mailing address
1205 S 7TH AVE STE 105
PHOENIX AZ
85007-3913
US
V. Phone/Fax
- Phone: 520-301-2400
- Fax:
- Phone: 602-416-7652
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHERYL
BOYLE
Title or Position: DIRECTOR, REV CYCLE MANAGEMENT
Credential:
Phone: 737-600-6039