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NPI Code Detail

MEDICARE: EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.

MEDICARE: EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1639026313
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : PO BOX 1231
Second Line :
City : TUCSON
State : AZ
Zip : 85702-1231
Country : US
Telephone Number : 520-670-3909
Fax Number : 520-309-2560
Provider Business Practice Location Address
First Line : 300 S 6TH ST
Second Line :
City : WILLIAMS
State : AZ
Zip : 86046-0110
Country : US
Telephone Number : 520-670-3909
Fax Number : 520-309-2560
Authorized Official
Title or Position : CEO
Name : CLINTON G KUNTZ
Credential :
Telephone Number : 520-601-0607
Provider Enumeration Date : 03/12/2026
Last Update Date : 06/24/2026

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