| Organization Name: | MORA VALLEY COMMUNITY HEALTH SERVICES INC |
| NPI Number: | 1508840117 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WANDA RENAY SALAZAR (FINANCE DIRECTOR) |
| Mailing Address: | 13 Mora Valley Clinic Road State Hwy 518 Mile Marker 26 Mora |
| State: | NM US |
| Postal Code: | 877320209 |
| Phone Number: | 5753875069 |
| Fax Number: | 5753879011 |
| NPI Enumeration Date: | 12/06/2005 |
| NPI Last Update Date: | 01/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 6333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |