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Organization

CHIRICAHUA COMMUNITY HEALTH CENTERS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN P MELK (CEO)
(520) 364-6852
Entity
Organization

Contact information

Practice address
10566 N HIGHWAY 191, ELFRIDA, AZ 85610-9021
(520) 642-2222
(520) 364-4261
Mailing address
1205 F AVENUE, DOUGLAS, AZ 85607
(520) 364-6852
(520) 364-4261

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OTC0924
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
941042
AZ
Enumeration date
02/28/2007
Last updated
09/01/2021
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