Organization Name: | UNITED COMMUNITY HEALTH CENTER MARIA AUXILLADORA. INC. |
NPI Number: | 1093766867 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RODOLFO JIMENEZ (EXECUTIVE DIRECTOR) |
Mailing Address: | 1260 S Campbell Ave Building 1 Green Valley |
State: | AZ US |
Postal Code: | 856140503 |
Phone Number: | 5206253691 |
Fax Number: | 5206252894 |
NPI Enumeration Date: | 05/15/2006 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |