Provider Demographics
NPI:1194135152
Name:CONNECTIONSAZ, LLC
Entity type:Organization
Organization Name:CONNECTIONSAZ, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER NETWORK MANAGEMENT ASSOC
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TALAS-DENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MHN, BSHCM
Authorized Official - Phone:602-416-7647
Mailing Address - Street 1:2390 E CAMELBACK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3479
Mailing Address - Country:US
Mailing Address - Phone:602-253-5100
Mailing Address - Fax:866-882-5456
Practice Address - Street 1:1201 S 7TH AVE STE 150A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-4075
Practice Address - Country:US
Practice Address - Phone:602-416-7600
Practice Address - Fax:866-882-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC7437261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z222888OtherMEDICARE
AZOTC9273OtherSTATE LICENSE
AZ942221Medicaid