Organization
ALAGA HOME HEALTH LLC
Active
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
(708) 248-0049
Mailing address
PO BOX 522, HUMBOLDT, AZ 86329-0522
(708) 248-0049
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
10/07/2023
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