Provider Demographics
NPI:1104544378
Name:MIGRANT HEALTH CENTER WESTERN REGION, INC.
Entity type:Organization
Organization Name:MIGRANT HEALTH CENTER WESTERN REGION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-831-5800
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0190
Mailing Address - Country:US
Mailing Address - Phone:787-831-5800
Mailing Address - Fax:787-832-0740
Practice Address - Street 1:180 RES CANDELARIA # 186
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-2714
Practice Address - Country:US
Practice Address - Phone:787-908-1342
Practice Address - Fax:787-832-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)