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
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1124978333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	450 W PASEO REDONDO
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-8274
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-670-3774

Provider Business Practice Location Address
First Line	:	4888 N STONE AVE UNIT 120
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5749
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	:	01/29/2026
Last Update Date	:	04/15/2026

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