Healthcare Provider Details

I. General information

NPI: 1174933246
Provider Name (Legal Business Name): CARING CONNECTIONS FOR SPECIAL NEEDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 E 15TH ST
DOUGLAS AZ
85607-2502
US

IV. Provider business mailing address

7447 E 22ND ST
TUCSON AZ
85710-6428
US

V. Phone/Fax

Practice location:
  • Phone: 520-639-9006
  • Fax: 520-721-6991
Mailing address:
  • Phone: 520-639-9006
  • Fax: 520-721-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberOTC8362
License Number StateAZ

VIII. Authorized Official

Name: REX GLENN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 520-686-0884