| NPI | 1013213404 |
|---|---|
| Other Name | MARIPOSA COMMUNITY HEALTH CENTER, INC - DENTAL, RIO RICO |
| Entity Type | Organization |
| Authorized Contact | DANIEL PREVOST Chief Executive Officer 520-761-2128 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0001X Dentist, Dental Public Health | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 163W00000X Registered Nurse | |
| 164W00000X Licensed Practical Nurse | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2024-04-10 |