Provider Demographics
NPI:1992197537
Name:CONNECT THE DOTS, LLC
Entity Type:Organization
Organization Name:CONNECT THE DOTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:MARI
Authorized Official - Last Name:OLIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:209-471-7962
Mailing Address - Street 1:5186 TREOSTI PL
Mailing Address - Street 2:
Mailing Address - City:VALLEY SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95252-8772
Mailing Address - Country:US
Mailing Address - Phone:209-471-7962
Mailing Address - Fax:
Practice Address - Street 1:5186 TREOSTI PL
Practice Address - Street 2:
Practice Address - City:VALLEY SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95252-8772
Practice Address - Country:US
Practice Address - Phone:209-471-7962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABACB# 1-14-15715251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health