Organization
CHIRICAHUA COMMUNITY HEALTH CENTERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN P MELK MD (CEO)
(520) 364-6852
Entity
Organization
Contact information
Practice address
155 CALLE PORTAL, SUITE 700, SIERRA VISTA, AZ 85635-2900
(520) 459-3011
(520) 364-4261
Mailing address
1205 F AVE, DOUGLAS, AZ 85607-1920
(520) 364-1429
(520) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945865
—
AZ
Enumeration date
06/23/2010
Last updated
09/01/2021
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