Provider Demographics
NPI:1457150013
Name:MAS COMUNIDAD
Entity type:Organization
Organization Name:MAS COMUNIDAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIGUELANJEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-587-1792
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:PENASCO
Mailing Address - State:NM
Mailing Address - Zip Code:87553-0237
Mailing Address - Country:US
Mailing Address - Phone:575-587-1792
Mailing Address - Fax:575-587-1055
Practice Address - Street 1:14156 STATE ROAD 75
Practice Address - Street 2:
Practice Address - City:PENASCO
Practice Address - State:NM
Practice Address - Zip Code:87553
Practice Address - Country:US
Practice Address - Phone:575-587-1792
Practice Address - Fax:575-587-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty