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General NPI Number Information
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NPI Number | 1184019457
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Entity Type | Organization
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Legal Business Name | APPLIED BEHAVIOR CONNECTIONS LLC
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 5160 SUNSET LN
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-4230
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Country | US
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Telephone | 801-935-5796
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Fax | 801-396-2828
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Provider Business Mailing Address
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Address Line | 5160 SUNSET LN
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-4230
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Country | US
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Telephone | 801-935-5796
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Fax | 801-396-2828
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Authorized Official
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Title or Position | CO-FOUNDER/CLINICAL DIRECTOR
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Name | MARIA CACERES-LOVELESS
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Credential | MA BCBA
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Telephone | 801-935-5796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1022390
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License Number State | UT
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