Healthcare Provider Details

I. General information

NPI: 1528311958
Provider Name (Legal Business Name): UNITED COMMUNITY HEALTH CENTER - MARIA AUXILIADORA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 06/20/2025
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13299 E COLOSSAL CAVE RD
VAIL AZ
85641-9001
US

IV. Provider business mailing address

1260 S CAMPBELL AVE BUILDING 2
GREEN VALLEY AZ
85614-0503
US

V. Phone/Fax

Practice location:
  • Phone: 520-407-5606
  • Fax:
Mailing address:
  • Phone: 520-407-5606
  • Fax: 520-625-8504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JON REARDON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSW, MBA
Phone: 520-407-5609