Organization
MARIPOSA SKILLED NURSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PEMBERTON (OWNER/PRESIDENT)
(281) 704-7941
Entity
Organization
Contact information
Practice address
3320 WOLF TAIL LOOP NE, RIO RANCHO, NM 87144-7887
(505) 356-2176
Mailing address
3320 WOLF TAIL LOOP NE, RIO RANCHO, NM 87144-7887
(505) 356-2176
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/11/2025
Last updated
12/18/2025
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