Alaga Health Chronic Care Management LLC
Clinic/Center, Health Services in Prescott, AZ. Organization (NPI-2).
NPI number1215631205
StatusActive
Last updated in NPPESJan 31, 2024
Details
- NPI
- 1215631205
- Entity type
- Organization (NPI-2)
- Legal business name
- Alaga Health Chronic Care Management LLC
- Organization subpart
- No
- Enumeration date
- Mar 27, 2023
- Certification date
- Jan 31, 2024
- Last updated
- Jan 31, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | – | – | Yes |
| 1835P2201X | Pharmacist, Ambulatory Care | – | – | |
| 261Q00000X | Clinic/Center | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 363LA2200X | Nurse Practitioner, Adult Health | – | – | |
| 363LG0600X | Nurse Practitioner, Gerontology | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Other names
- Alaga Health (Doing Business As)
Practice location
3250 Gateway Blvd Ste 110Prescott, AZ 86303-6846
Phone 928-350-7900
Mailing address
Po Box 522Humboldt, AZ 86329-0522
Authorized official
John Michael Mata
Administrator
7082480049
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