Active NPI
Marana Health Center, Inc
Doing business as Freedom Park
- Federally Qualified Health Center (FQHC)
- Tucson, AZ
National Provider Identifier
1023177250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- MARANA HEALTH CENTER, INC
- Doing business as
- Freedom Park
- Practice address
- 5000 E 29TH St
Tucson, AZ 85711-6401 - Phone
- (520) 790-8500
- Fax
- (520) 790-8505
- NPI assigned
- Dec 6, 2006
- Last updated
- Feb 20, 2014
- Organization subpart
- Yes
- Parent organization
- MARANA HEALTH CENTER, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Clinton Kuntz
- Title
- Ceo
- Phone
- (520) 682-4111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | AZ | Primary |
Addresses
Primary practice location
5000 E 29TH St
Tucson, AZ 85711-6401
Mailing address
PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 417356 | Medicaid | AZ | |
| 329592 | Other | AZ | AHCCCS GROUP NUMBER |
Other names 1
- Freedom Park
National Provider Directory
National Provider Directory- Part of
- Marana Community Clinic
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1392854400000",
"number": "1023177250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 188",
"city": "MARANA",
"state": "AZ",
"postal_code": "856530188",
"telephone_number": "520-682-4111",
"fax_number": "520-818-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 E 29TH ST",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857116401",
"telephone_number": "520-790-8500",
"fax_number": "520-790-8505"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARANA HEALTH CENTER, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MARANA HEALTH CENTER, INC",
"enumeration_date": "2006-12-06",
"last_updated": "2014-02-20",
"status": "A",
"authorized_official_last_name": "KUNTZ",
"authorized_official_first_name": "CLINTON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "520-682-4111"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "AZ",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "417356",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS GROUP NUMBER",
"identifier": "329592",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Freedom Park",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tucson, AZ
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- Marana Health Center Inc (MHC Healthcare Z Mansion)
- Marana Health Center Inc (Ina Health Center)
- Marana Health Center Inc (MHC Healthcare Z Mansion)
- Marana Health Center Inc
- Marana Health Center, Inc (MHC Healthcare Ina Pharmacy)
- Marana Health Center, Inc (Rita Ranch Family Health Center)
- Marana Health Center, Inc (MHC Integrated Care Pharmacy)
- Marana Health Center, Inc (Santa Catalina Health Center)
- Marana Health Center, Inc (MHC Westside Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.