Black Canyon Community Health Center
NPI #1992438642 in Black Canyon City, Arizona
Provider Information
- NPI Number
- 1992438642
- Entity Type
- Organization
- Organization Name
- Black Canyon Community Health Center
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Jul 8, 2022
- Last Updated
- Dec 16, 2022
Practice Location
- Address
- 19251 E OASIS DR
- State
- Arizona
- ZIP Code
- 85324-8878
- Phone
- (623) 374-0200
Authorized Official
- Name
- RANDY CHARLES HANCOCK, DO
- Title
- CEO
- Phone
- (623) 374-0200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
| Family Medicine - Adolescent Medicine — Adolescent Medicine |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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