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General NPI Number Information
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NPI Number | 1528915287
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Entity Type | Organization
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Legal Business Name | EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 1501 S YALE ST STE 252
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-7336
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Country | US
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Telephone | 520-670-3909
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Fax | 520-309-2560
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Provider Business Mailing Address
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Address Line | PO BOX 1231
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City | TUCSON
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State | AZ
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Zip | 85702-1231
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Country | US
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Telephone | 520-670-3909
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Fax | 520-309-2560
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Authorized Official
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Title or Position | CEO
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Name | CLINTON G KUNTZ
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Credential |
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Telephone | 520-601-0607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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