Provider Demographics
NPI:1922545755
Name:CONNECTIONSACCESS, LLC
Entity Type:Organization
Organization Name:CONNECTIONSACCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIFOWOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-416-7616
Mailing Address - Street 1:1135 N JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3973
Mailing Address - Country:US
Mailing Address - Phone:520-448-0670
Mailing Address - Fax:866-882-5456
Practice Address - Street 1:1135 N JONES BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3973
Practice Address - Country:US
Practice Address - Phone:520-301-2400
Practice Address - Fax:866-882-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone