Organization
ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC
Active
Other names
Alaga Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL MATA AGACNP-BC (ADMINISTRATOR)
(708) 248-0049
Entity
Organization
Contact information
Practice address
3250 GATEWAY BLVD STE 110, PRESCOTT, AZ 86303-6846
(928) 350-7900
Mailing address
PO BOX 522, HUMBOLDT, AZ 86329-0522
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/27/2023
Last updated
01/31/2024
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