CANYONLANDS COMMUNITY HEALTH CARE (NPI# 1548238876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548238876 |
| Entity Type | Organization |
| Organization Name | CANYONLANDS COMMUNITY HEALTH CARE |
| Other Organization Name | FREDONIA COMMUNITY HEALTH CENTER |
| Practice Address |
100 E Wood Hill Road Fredonia AZ 86022-0175 |
| Mailing Address |
Po Box 1625 Page AZ 86040-1625 |
| Practice Telephone | 9286436215 |
| Practice Fax Number | 9286436218 |
| Mailing Telephone | 9286459675 |
| Mailing Fax Number | 9286453030 |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | ELIZABETH G LATHAM (CEO) |
| Authorized Official Telephone | 9286459675 |
| Is Organization Subpart | Y |
| Parent Organization Name | CANYONLANDS COMMUNITY HEALTH CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 594029 | 05 |
| Other Name | Type Code |
|---|---|
| Fredonia Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134568660 | Canyonlands Community Health Care | Clinic/Center | 10 Ward Canyon Road, #a, Clifton, AZ 85533 | 2013-06-18 |
| 1417218876 | Canyonlands Community Health Care | Clinic/Center | 5860 South Hospital Drive, Ste 102, Globe, AZ 85501 | 2012-06-01 |
| 1598052466 | Canyonlands Community Health Care | Clinic/Center | 618 S Central Ave, Safford, AZ 85546-2721 | 2011-06-29 |
| 1861558595 | Canyonlands Community Health Care | Clinic/Center | 2016 West 16th Street, Safford, AZ 85546 | 2006-12-28 |
| 1609966860 | Canyonlands Community Health Care | Dentist | 827 Vista Avenue, Page, AZ 86040-1625 | 2006-10-16 |
| 1154380392 | Canyonlands Community Health Care | Family Medicine | Chilchinbeto Chapter House Complex, Chilchinbeto, AZ 86033-1496 | 2006-03-17 |
| 1669441564 | Canyonlands Community Health Care | Family Medicine | 440 North Navajo Drive, Page, AZ 86040-1625 | 2006-03-15 |
| 1780653741 | Canyonlands Community Health Care | Family Medicine | 3272 E Rio Virgin Road, Littlefield, AZ 86432-3200 | 2006-03-14 |
| 1568430676 | Canyonlands Community Health Care | Family Medicine | Kaibeto Boarding School Dorm # 4, Kaibeto, AZ 86053-2121 | 2006-03-14 |
| 1184283335 | Canyonlands Community Health Care | Pharmacy | Chilchinbeto Chapter House Complex, Chilchinbeto, AZ 86033 | 2019-06-11 |
| Street Address |
100 E WOOD HILL ROAD |
| City | FREDONIA |
| State | AZ |
| Zip Code | 86022-0175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013516020 | Josey K Morrison | Massage Therapist | 1485 East 3200 South, Cane Beds, AZ 86022 | 2020-10-21 |
| 1023638806 | David Armstrong Lambert | Speech-Language Pathologist | 221 East Hortt Strett, Fredonia, AZ 86022 | 2020-04-21 |
| 1003315151 | Thomas Charles Kinne II | Respite Care | 314 Aspen Street, Fredonia, AZ 86022 | 2018-02-05 |
| 1629339437 | Re-creation Retreat LLC | Substance Abuse Rehabilitation Facility | 455 South Main, Fredonia, AZ 86022 | 2012-06-07 |
| 1659686897 | James Gray Millward | Dentist | 100 E. Wood Hill Rd., Fredonia, AZ 86022 | 2010-08-12 |
| 1518134626 | Deanne Lazenby Peterson | Occupational Therapist | 10 Rosecliff Lane, Cane Beds, AZ 86022 | 2008-05-08 |
| 1811189103 | Fredonia-moccasin Unified School District | Local Education Agency (LEA) | 221 East Hortt Street, Fredonia, AZ 86022 | 2007-08-10 |
| 1265556336 | Guy Ronald Finicum | Counselor | 2800 N. 50 E., Fredonia, AZ 86022 | 2007-03-16 |
| 1144368010 | Randy K Soderquist | Social Worker | 465 South Main, Fredonia, AZ 86022 | 2007-02-02 |
| 1427006469 | William J Trudell | Counselor | 850 E. Hwy 89a, Fredonia, AZ 86022 | 2006-05-04 |
| Find all providers in zip 86022 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926204 | Avondale Fire & Medical | Clinic/Center | 125 S Avondale Blvd Ste 100, Avondale, AZ 85323-5214 | 2020-09-14 |
| 1770107476 | Buena Vista Recovery, LLC | Clinic/Center | 8171 E Indian Bend Rd Ste 100, Scottsdale, AZ 85250-4830 | 2020-05-29 |
| 1841771920 | Harmony Health and Wellness Foundation | Clinic/Center | 5220 N Dysart Rd Building C, Litchfield Park, AZ 85340 | 2018-08-27 |
| 1427536770 | Mulligan's Manor, Inc. | Clinic/Center | 4701 S Lakeshore Dr Unit 1, Tempe, AZ 85282-7169 | 2018-07-30 |
| 1033614060 | Devereux Foundation | Clinic/Center | 1837 S Mesa Dr Ste A200, Mesa, AZ 85210-6219 | 2018-03-30 |
| 1841703253 | Tri-state Community Healthcare Center | Clinic/Center | 8700 S Highway 95, Mohave Valley, AZ 86440-8519 | 2017-11-07 |
| 1477082642 | Horizon Health and Wellness, Inc. | Clinic/Center | 450 W Adamsville Rd Ste A, Florence, AZ 85132 | 2017-06-09 |
| 1649710328 | City of Surprise | Clinic/Center | 14250 W Statler Plz Ste 101, Surprise, AZ 85374-7474 | 2017-03-01 |
| 1144696097 | Wesley Community Center, Inc | Clinic/Center | 1625 N 39th Ave, Phoenix, AZ 85009-2149 | 2015-08-14 |
| 1487062667 | Pph Franchise Holdings LLC | Clinic/Center | 8324 E Hartford Dr Ste 200, Scottsdale, AZ 85255-7801 | 2014-07-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.