Provider Demographics
NPI:1265015051
Name:AZ'ULES CONNECTIONS, LLC
Entity Type:Organization
Organization Name:AZ'ULES CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MINI'IMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:860-209-6228
Mailing Address - Street 1:1975 SNYDER AVE
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-1713
Mailing Address - Country:US
Mailing Address - Phone:860-209-6228
Mailing Address - Fax:
Practice Address - Street 1:1975 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-1713
Practice Address - Country:US
Practice Address - Phone:860-209-6228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AZ'ULES CONNECTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health