# MARIPOSA PRIMARY HOME CARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669708236
- **Authorized official:** MR. MARK HARLEY FERGUSON (ADMINISTRATOR)
- **Authorized official phone:** (210) 218-2180

## Contact information

- **Practice address:** 10107 MONTOYA DR, LAREDO, TX 78045-6400
- **Practice address phone:** (210) 218-2180
- **Practice address fax:** (210) 438-8102
- **Mailing address:** 10107 MONTOYA DR, LAREDO, TX 78045-6400
- **Mailing address phone:** (210) 218-2180
- **Mailing address fax:** (210) 438-8102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/02/2009
- **Last updated:** 11/02/2009