{"npi":"1487602736","type":"NPI-2","status":"active","name":{"display":"El Rio Santa Cruz Neighborhood Health Center, INC","other":[],"organization_name":"EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC","authorised_official":"Clinton Kuntz"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":"AZ","license":"OTC0006"}]},"addresses":[{"purpose":"LOCATION","street_1":"839 W CONGRESS ST","city":"TUCSON","state":"AZ","postal_code":"857452819","country_code":"US","phone":"5206703909","fax":"5206703792"},{"purpose":"MAILING","street_1":"PO BOX 1231","city":"TUCSON","state":"AZ","postal_code":"857021231","country_code":"US","phone":"5206703909","fax":"5206703774"}],"license":{"state":"AZ","number":"OTC0006"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"947887","state":"AZ","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040205000098","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"AZ","pac_id":"6305739244"},{"enrlmt_id":"O20040720001133","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"AZ","pac_id":"6305739244"},{"enrlmt_id":"O20100823000887","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"AZ","pac_id":"6305739244"}]},"enumeration_date":"2006-05-05","last_updated":"2025-05-28","_meta":{"source":"NPPES","snapshot_date":"2025-05-28","doc_url":"https://findmynpi.com/api"}}