CHIRICAHUA COMMUNITY HEALTH CENTERS INC NPI 1811472665

NPI Information

NPI: 1811472665
Provider Name: CHIRICAHUA COMMUNITY HEALTH CENTERS, INC

Doing Business As: EARLY CHILDHOOD CENTER OF EXCELLANCE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1151 16TH STREET
DOUGLAS, AZ
ZIP 85607
Phone: (520) 364-5437
Get Directions

CHIRICAHUA COMMUNITY HEALTH CENTERS, INC is a federally qualified health center (fqhc) clinic center in Douglas, AZ. CHIRICAHUA COMMUNITY HEALTH CENTERS, INC NPI is 1811472665. The provider is registered as an organization entity type.
The provider Is Doing Business As Early Childhood Center Of Excellance.

The provider's business location address is:

1151 16TH STREET
DOUGLAS, AZ
ZIP 85607
Phone: (520) 364-5437

The provider's authorized official is Jonathan P Melk .
The authorized official title is Ceo and has the following contact phone number (520) 364-1429.

The CLIA number assigned to this NPI record is 03D2150404 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2018 and was last updated on 9/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	435308	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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