| Canyonlands Community Health Care | |
| 
					10 Ward Canyon Road #a Clifton AZ 85533  | |
| (928) 645-9675 | |
| Not Available | 
| Full Name | Canyonlands Community Health Care | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 10 Ward Canyon Road, Clifton, Arizona | 
| Authorized Official Name and Position | Christopher J Hansen (CHIEF EXECUTIVE OFFICER) | 
| Authorized Official Contact | 9286459675 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Canyonlands Community Health Care Po Box 1625 827 Vista Ave Page AZ 86040-1625 Ph: (928) 645-9675  | Canyonlands Community Health Care 10 Ward Canyon Road #a Clifton AZ 85533 Ph: (928) 645-9675  | 
| NPI Number | 1134568660 | 
|---|---|
| Provider Enumeration Date | 06/18/2013 | 
| Last Update Date | 09/23/2021 | 
| Medicare PECOS PAC ID | 4082509591 | 
|---|---|
| Medicare Enrollment ID | O20141205000423 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1134568660 | NPI | - | NPPES | 
| 031811 | Other | AZ | CORPORATE PTAN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |