| Organization Name: | MAYIMRAPHA COMPREHENSIVE HEALTHCARE, INC |
| NPI Number: | 1457639262 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELANIE UKANWA (OWNER/PHYSICIAN PROVIDER) |
| Mailing Address: | 765 E Roosevelt Avenue Grants |
| State: | NM US |
| Postal Code: | 870202113 |
| Phone Number: | 5052875365 |
| Fax Number: | 5052003756 |
| NPI Enumeration Date: | 07/27/2011 |
| NPI Last Update Date: | 05/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | MD2006-0291 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |