Organization Name: | UNITED COMMUNITY HEALTH CENTERS MARIA AUXILIADORA, INC. |
NPI Number: | 1922050319 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANNA GONZALES (EXECUTIVE DIRECTOR) |
Mailing Address: | 17388 W 3rd Street Arivaca |
State: | AZ US |
Postal Code: | 85601 |
Phone Number: | 5204075500 |
Fax Number: | 5203982613 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 04/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 01/04/2007 |
NPI Reactivation Date: | 06/18/2008 |
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: |