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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