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General NPI Number Information
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NPI Number | 1508840117
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Entity Type | Organization
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Legal Business Name | MORA VALLEY COMMUNITY HEALTH SERVICES INC
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 3 MORA VALLEY CLINIC RD
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City | MORA
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State | NM
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Zip | 87732-2202
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Country | US
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Telephone | 877-271-2201
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 209
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City | MORA
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State | NM
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Zip | 87732-0209
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Country | US
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Telephone | 877-271-2201
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MRS. CARLA MELENDEZ
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Credential |
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Telephone | 877-271-2201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 6333
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License Number State | NM
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