Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Parent organization
CANYONLANDS COMMUNITY HEALTH CARE
Other names
Canyonlands Health Care - Clifton
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANYONLANDS COMMUNITY HEALTH CARE
Authorized official
CHRISTOPHER J HANSEN (CHIEF EXECUTIVE OFFICER)
(928) 645-9675
Entity
Organization
Contact information
Practice address
10 WARD CANYON ROAD, #A, CLIFTON, AZ 85533
(928) 645-9675
Mailing address
PO BOX 1625, 827 VISTA AVE, PAGE, AZ 86040-1625
(928) 645-9675
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031811
CORPORATE PTAN
AZ
Enumeration date
06/18/2013
Last updated
09/23/2021
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