| NPI | 1578264362 |
|---|---|
| Other Name | MARIPOSA NOGALES NORTH |
| 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 | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-03-17 |