| Organization Name: | AJO COMMUNITY HEALTH CENTER |
| NPI Number: | 1114037496 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FRAN DRIVER (CEO) |
| Mailing Address: | 410 N Malacate St Ajo |
| State: | AZ US |
| Postal Code: | 853212254 |
| Phone Number: | 5203875651 |
| Fax Number: | 5203875347 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 01/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | OTC-0274 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |