Healthcare Provider Details

I. General information

NPI: 1891512927
Provider Name (Legal Business Name): DESERT SENITA COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1269 N PROMENADE PKWY STE 127
CASA GRANDE AZ
85194-5425
US

IV. Provider business mailing address

410 N MALACATE ST
AJO AZ
85321-2254
US

V. Phone/Fax

Practice location:
  • Phone: 520-387-5651
  • Fax:
Mailing address:
  • Phone: 520-387-5651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER WARD
Title or Position: CFO
Credential:
Phone: 520-387-5651