Organization
MARIPOSA COMMUNITY HEALTH CENTER, INC
Active
Organization
MARIPOSA COMMUNITY HEALTH CENTER, INC
Active
Other names
Mariposa Mesquite
Organization subpart
No
Provider details
NPI number
Authorized official
AMY TAYLOR (CHIEF EXECUTIVE OFFICER)
(520) 761-2128
Entity
Organization
Contact information
Practice address
1835 N MASTICK WAY, NOGALES, AZ 85621-1064
(520) 281-1550
(520) 281-4487
Mailing address
825 N GRAND AVE STE 100, NOGALES, AZ 85621-2385
(520) 761-2128
(520) 281-1112
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-1884
MEDICARE PART A GROUP #
AZ
05
—
931890
—
AZ
01
—
ZFQ03-1884
MEDICARE PART B GROUP #
AZ
Enumeration date
02/02/2011
Last updated
02/10/2025
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