Organization
ALAGA HEALTH CHRONIC CARE MANAGEMENT LLC
Active
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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