1174933246 NPI number — CARING CONNECTIONS FOR SPECIAL NEEDS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174933246 NPI number — CARING CONNECTIONS FOR SPECIAL NEEDS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING CONNECTIONS FOR SPECIAL NEEDS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174933246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
921 S PRUDENCE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85710-5020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-639-9006
Provider Business Mailing Address Fax Number:
520-721-6991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1019 F AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOUGLAS
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-364-3162
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CASEY
Authorized Official First Name:
SHANNON
Authorized Official Middle Name:
C
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
520-639-9006

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  OTC8362 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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