Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Parent organization
CANYONLANDS COMMUNITY HEALTH CARE
Other names
Canyonlands Health Care - Beaver Dam
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANYONLANDS COMMUNITY HEALTH CARE
Authorized official
CHRISTOPHER J HANSEN (CEO)
(928) 645-9675
Entity
Organization
Contact information
Practice address
3272 E RIO VIRGIN ROAD, LITTLEFIELD, AZ 86432-3200
(928) 347-5971
(928) 347-5793
Mailing address
P O BOX 1625, 827 VISTA AVENUE, PAGE, AZ 86040-1625
(928) 645-9675
(928) 645-2626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
207Q00000X
Family Medicine Physician
—
AZ
207V00000X
Obstetrics & Gynecology Physician
—
—
261QC1500X
Community Health Clinic/Center
—
AZ
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509882
—
NV
05
—
432857
—
AZ
05
—
594011
—
AZ
Enumeration date
03/14/2006
Last updated
09/23/2021
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