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General NPI Number Information
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NPI Number | 1548210461
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Entity Type | Organization
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Legal Business Name | UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 275 W CONTINENTAL RD
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City | GREEN VALLEY
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State | AZ
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Zip | 85622
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Country | US
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Telephone | 520-625-4401
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Fax | 520-547-3994
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Provider Business Mailing Address
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Address Line | 81 W ESPERANZA BLVD STE 201
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-2667
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Country | US
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Telephone | 520-625-4401
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Fax | 520-625-8504
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JON REARDON
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Credential | MSW, MBA
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Telephone | 520-407-5609
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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 | OTC-3915
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License Number State | AZ
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