Organization
MARIPOSA SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON MCDERMOTT (PRESIDENT)
(505) 234-1744
Entity
Organization
Contact information
Practice address
3811 ACADEMY PKWY S NE, ALBUQUERQUE, NM 87108
(505) 234-1744
(505) 234-1733
Mailing address
3811 ACADEMY PKWY S NE, ALBUQUERQUE, NM 87109
(505) 234-1744
(505) 234-1733
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1T3404
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1T3404
—
NM
Enumeration date
07/11/2012
Last updated
07/16/2018
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