Healthcare Provider Details

I. General information

NPI: 1932359833
Provider Name (Legal Business Name): TRI CONNECTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 N 1120 W
PROVO UT
84604-1044
US

IV. Provider business mailing address

1921 N 1120 W
PROVO UT
84604-1044
US

V. Phone/Fax

Practice location:
  • Phone: 801-343-3900
  • Fax: 801-343-3925
Mailing address:
  • Phone: 801-343-3900
  • Fax: 801-343-3925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number14507
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID HUGH HENNESSEY
Title or Position: CEO / EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 801-343-3900