Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Parent organization
CANYONLANDS COMMUNITY HEALTH CARE
Other names
Canyonlands Health Care - Safford Integrated
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANYONLANDS COMMUNITY HEALTH CARE
Authorized official
CHRISTOPHER HANSEN (CEO)
(928) 645-9675
Entity
Organization
Contact information
Practice address
1615 S 1ST AVE, SAFFORD, AZ 85546-2103
(928) 348-1708
Mailing address
PO BOX 1625, PAGE, AZ 86040-1625
(928) 645-9675
(928) 645-2626
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OTC7466
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031811
CORPORATE PTAN
—
01
—
1609966860
CORPORATE NPI
—
01
—
OTC7466
STATE FACILITY LICENSE
AZ
Enumeration date
04/27/2017
Last updated
09/23/2021
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