Provider Demographics
NPI:1013892041
Name:MARIPOZA GROUP LLC
Entity type:Organization
Organization Name:MARIPOZA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CORA - AMARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-307-5968
Mailing Address - Street 1:20923 CAPULIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-2148
Mailing Address - Country:US
Mailing Address - Phone:347-307-5968
Mailing Address - Fax:
Practice Address - Street 1:20923 CAPULIN LAKES DR
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-2148
Practice Address - Country:US
Practice Address - Phone:347-307-5968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty