Provider Demographics
NPI:1376293472
Name:CONNECTIONSAZ, LLC
Entity type:Organization
Organization Name:CONNECTIONSAZ, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER NETWORK MANAGMENT ASSOC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:737-600-6039
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:602-416-7600
Mailing Address - Fax:
Practice Address - Street 1:1201 S 7TH AVE STE 150D
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ156807Medicaid
AZBH7319OtherLICENSE