Black Canyon Community Health Center - Medicare Mental Health Clinic in Black Canyon City, AZ

Black Canyon Community Health Center is a medicare enrolled mental health clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Black Canyon City, Arizona. The current practice location for Black Canyon Community Health Center is 19251 E Oasis Dr, Black Canyon City, Arizona. For appointments, you can reach them via phone at (623) 374-0200. The mailing address for Black Canyon Community Health Center is Po Box 1958, Black Canyon City, Arizona and phone number is (623) 374-0200.

Black Canyon Community Health Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1992438642. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (623) 374-0200.

Contact Information

Black Canyon Community Health Center
19251 E Oasis Dr
Black Canyon City
AZ 85324-8878
(623) 374-0200
(623) 374-5576

Mental Health Clinic Profile

Full NameBlack Canyon Community Health Center
SpecialityClinic/Center
Location19251 E Oasis Dr, Black Canyon City, Arizona
Authorized Official Name and PositionRandy Charles Hancock (CEO)
Authorized Official Contact6233740200
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Black Canyon Community Health Center
Po Box 1958
Black Canyon City
AZ 85324-1958

Ph: (623) 374-0200
Black Canyon Community Health Center
19251 E Oasis Dr
Black Canyon City
AZ 85324-8878

Ph: (623) 374-0200

NPI Details:

NPI Number1992438642
Provider Enumeration Date07/08/2022
Last Update Date12/16/2022
Certification Date12/16/2022

Medicare PECOS Information:

Medicare PECOS PAC ID6406900331
Medicare Enrollment IDO20220805002436

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Medical Identifiers

Medical identifiers for Black Canyon Community Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1992438642NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor (* (Not Available))Secondary
207QA0000XFamily Medicine - Adolescent Medicine (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

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Clinic/Center in Black Canyon City, AZ


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