OrganizationActive
Black Canyon Community Health Center Inc.
NPI 1124730627 · Federally Qualified Health Center (FQHC) · Mayer, AZ
Provider details
- NPI number
- 1124730627
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Randy Hancock, Ceo(623) 374-0200
Specialties & taxonomies
Ambulatory Health Care Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
17301 E Spring Valley Rd Ste F
Mayer, AZ 86333-4263
Phone: (623) 374-0200
Fax: (623) 374-5576
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 12
Black Canyon City, AZ 85324-0012
Registry dates
- Enumerated
- 2022-12-16
- Last updated
- 2022-12-16
- Certified
- 2022-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.