| Organization Name: | MORA VALLEY COMMUNITY HEALTH SERVICES, INC. |
| NPI Number: | 1396104964 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIAN F BARELA (EXECUTIVE DIRECTOR) |
| Mailing Address: | 10 Ranger Dr Mora |
| State: | NM US |
| Postal Code: | 87732 |
| Phone Number: | 5753873117 |
| Fax Number: | |
| NPI Enumeration Date: | 02/11/2016 |
| NPI Last Update Date: | 02/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | 6333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |