Semiconductor devices and methods of manufacture are described herein. The methods include forming a local organic interconnect (LOI) by forming a stack of conductive traces embedded in a passivation material, forming first and second local contacts over the passivation material, the second local contact being electrically coupled to the first local contact by a first conductive trace of the stack. The methods further include forming a backside redistribution layer (RDL) and a front side RDL on opposite sides of the LOI with TMVs electrically coupling the backside and front side RDLs to one another. First and second external contacts are formed over the backside RDL for mounting of semiconductor devices, the first and second external contacts being electrically connected to one another by the LOI. An interconnect structure is attached to the front side RDL for further routing. External connectors electrically coupled to the external contacts at the backside RDL.