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Organization

MARANA HEALTH CENTER, INC

Active
Parent organization
MARANA HEALTH CENTER, INC
Other names
Freedom Park
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARANA HEALTH CENTER, INC
Authorized official
CLINTON KUNTZ (CEO)
(520) 682-4111
Entity
Organization

Contact information

Practice address
5000 E 29TH ST, TUCSON, AZ 85711-6401
(520) 790-8500
(520) 790-8505
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
329592
AHCCCS GROUP NUMBER
AZ
05
417356
AZ
Enumeration date
12/06/2006
Last updated
02/20/2014
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