| Freedom Park | |
|
5000 E 29th St Tucson AZ 85711-6401 | |
| (520) 790-8500 | |
| (520) 790-8505 |
| Full Name | Freedom Park |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5000 E 29th St, Tucson, Arizona |
| Authorized Official Name and Position | Clinton Kuntz (CEO) |
| Authorized Official Contact | 5206824111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom Park Po Box 188 Marana AZ 85653-0188 Ph: (520) 682-4111 | Freedom Park 5000 E 29th St Tucson AZ 85711-6401 Ph: (520) 790-8500 |
| NPI Number | 1023177250 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 02/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023177250 | NPI | - | NPPES |
| 417356 | Medicaid | AZ | |
| 329592 | Other | AZ | AHCCCS GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Arizona) | Primary |
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