Provider Demographics
NPI:1295028579
Name:POSITIVE CONNECTIONS, INC.
Entity Type:Organization
Organization Name:POSITIVE CONNECTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:LELAND
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-865-8759
Mailing Address - Street 1:1909 S 4250 W
Mailing Address - Street 2:STE B
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84104-4837
Mailing Address - Country:US
Mailing Address - Phone:801-746-5567
Mailing Address - Fax:801-746-1139
Practice Address - Street 1:1909 S 4250 W
Practice Address - Street 2:STE B
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-4837
Practice Address - Country:US
Practice Address - Phone:801-746-5567
Practice Address - Fax:801-746-1139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty