CANYONLANDS COMMUNITY HEALTH CARE; NPI #1144755182

Contact Information

CANYONLANDS COMMUNITY HEALTH CARE

1615 S 1ST AVE
SAFFORD, AZ 85546-2103

Phone: 928-348-1708
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for CANYONLANDS COMMUNITY HEALTH CARE

NPI # 1144755182

LBN Legal business name CANYONLANDS COMMUNITY HEALTH CARE

Authorized official CHRISTOPHER HANSEN - (CEO)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 04/27/2017

Last updated 09/23/2021 - About 5 years ago

Identifiers

AZ	License #	OTC7466
	Other	1609966860	CORPORATE NPI
	Other	031811	CORPORATE PTAN
AZ	Other	OTC7466	STATE FACILITY LICENSE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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