Healthcare Provider Details

I. General information

NPI: 1073449542
Provider Name (Legal Business Name): COURAGEOUS HEARTS ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7533 S CENTER VIEW CT STE 210
WEST JORDAN UT
84084-5527
US

IV. Provider business mailing address

7533 S CENTER VIEW CT STE 5915
WEST JORDAN UT
84084-5526
US

V. Phone/Fax

Practice location:
  • Phone: 844-693-4688
  • Fax:
Mailing address:
  • Phone: 844-693-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: YITZCHAK RENZONI
Title or Position: MANAGER
Credential:
Phone: 845-535-9728