Organization · Type 2 NPI

Canyonlands Community Health Care

Federally Qualified Health Center (FQHC) · Littlefield, AZ

NPI number 1780653741 Active

Practice location

3272 E Rio Virgin Road
Littlefield, AZ 86432-3200

Call (928) 347-5971 Map

Fax (928) 347-5793

Mailing address

P O Box 1625, 827 Vista Avenue
Page, AZ 86040-1625

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry	1223G0001X	None listed
Family Medicine Physician	207Q00000X	None listed
Family Medicine Physician	207Q00000X	None listed
Obstetrics & Gynecology Physician	207V00000X	None listed
Community Health Clinic/Center	261QC1500X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1780653741
Entity type: Organization (Type 2)
Issued: Mar 14, 2006
Last updated: Sep 23, 2021
Status: Active
Subpart: Yes of Canyonlands Community Health Care

Other names

<unavail>
Canyonlands Health Care - Beaver Dam · doing business as

Authorized official

Christopher J Hansen
CEO
(928) 645-9675

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780653741

Canyonlands Community Health Care's National Provider Identifier is 1780653741, issued on Mar 14, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Littlefield, AZ. The record was last updated on Sep 23, 2021.