Organization
MARIPOSA COMMUNITY HEALTH CENTER, INC
Active
Other names
Mariposa Nogales West
Organization subpart
No
Provider details
NPI number
Authorized official
AMY TAYLOR (CHIEF EXECUTIVE OFFICER)
(520) 761-2128
Entity
Organization
Contact information
Practice address
1209 W TARGET RANGE RD, NOGALES, AZ 85621-2466
(520) 287-4747
(520) 281-1112
Mailing address
825 N GRAND AVE STE 100, NOGALES, AZ 85621-1061
(520) 761-2128
(520) 281-1112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091922
—
AZ
Enumeration date
09/21/2020
Last updated
02/10/2025
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