Provider Demographics
NPI:1356096036
Name:CONNECTIONSMT, LLC
Entity Type:Organization
Organization Name:CONNECTIONSMT, LLC
Other - Org Name:GROUP ID
Other - Org Type:Other Name
Authorized Official - Title/Position:PROVIDER NETWORK MANAGMENT 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:
Authorized Official - Phone:623-273-6154
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 1:120 N 19TH AVE STE H
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3920
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:2022-02-21
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283Q00000XHospitalsPsychiatric Hospital
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty