Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Parent organization
CANYONLANDS COMMUNITY HEALTH CARE
Other names
Canyonlands Healthcare Globe
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
5860 SOUTH HOSPITAL DRIVE, STE 102, GLOBE, AZ 85501
(928) 402-0491
(928) 402-0490
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031811
CORPORATE PTAN
AZ
01
—
1619945904
CORPORATE NPI
AZ
05
—
933575
—
AZ
Enumeration date
06/01/2012
Last updated
09/23/2021
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