CTR066198_Debarment_Checks.pdf
PDF 339 KB Posted
- Attached to
- Master Agreement AZ|CTR066198
- Contract number
- CTR066198
- Issued by
- Arizona
About this file
These documents are corporate registration and compliance records for Mariposa Community Health Center, Inc., a non-profit healthcare organization located in Nogales, Arizona. The records include System for Award Management (SAM.gov) registration details, Arizona Corporation Commission entity information, and verification documents from the Office of Inspector General (OIG) exclusions database. The organization is a tax-exempt, domestic nonprofit corporation established on July 22, 1985, with an active registration status and located in Santa Cruz County, Arizona.
Mariposa Community Health Center is classified under the NAICS code 621498 for "All Other Outpatient Care Centers" and operates in the Health Care and Social Assistance business type. The organization's key leadership includes Dan Prevost as CEO (appointed 10/26/2022), with additional board directors such as Judith Claremon, Lou Jeong, Rudy Pina, and Robert Lineiro. The entity has an active SAM.gov registration valid through January 14, 2026, with a unique entity ID of T7KJKFWEKNR9. The documents confirm the organization has no active exclusions in federal databases and is registered for "All Awards" purposes, indicating potential eligibility for government contracts or grants in the healthcare sector.
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MARIPOSA COMMUNITY HEALTH CENTER, INC.
Unique Entity ID
T7KJKFWEKNR9
CAGE / NCAGE
3LPV8
Purpose of Registration
All Awards
Registration Status
Active Registration
Expiration Date
Jan 14, 2026
Physical Address
825 N Grand AVE
STE 100
Nogales, Arizona 85621-2385
United States
Mailing Address
825 N Grand AVE STE 100
Nogales, Arizona 85621-2385
United States
Business Information
Doing Business as
(blank)
Division Name
(blank)
Division Number
(blank)
Congressional District
Arizona 07
State / Country of Incorporation
Arizona / United States
URL
www.mariposachc.net
Registration Dates
Activation Date
Jan 16, 2025
Submission Date
Jan 14, 2025
Initial Registration Date
Nov 12, 2003
Entity Dates
Entity Start Date
Dec 1, 1985
Fiscal Year End Close Date
May 31
Immediate Owner
CAGE
(blank)
Legal Business Name
(blank)
Highest Level Owner
CAGE
(blank)
Legal Business Name
(blank)
Executive Compensation
Registrants in the System for Award Management (SAM) respond to the Executive Compensation questions in accordance with Section 6202 of
P.L. 110-252, amending the Federal Funding Accountability and Transparency Act (P.L. 109-282). This information is not displayed in SAM. It is sent to USAspending.gov for display in association with an eligible award. Maintaining an active registration in SAM demonstrates the registrant responded to the questions.
Proceedings Questions
Registrants in the System for Award Management (SAM.gov) respond to proceedings questions in accordance with FAR 52.209-7, FAR 52.209-9, or 2. C.F.R. 200 Appendix XII. Their responses are displayed in the responsibility/qualification section of SAM.gov. Maintaining an active registration in SAM.gov demonstrates the registrant responded to the proceedings questions.
Exclusion Summary
Active Exclusions Records?
No
SAM Search Authorization
I authorize my entity's non-sensitive information to be displayed in SAM public search results:
Yes
Entity Types
Business Types
Entity Structure
Corporate Entity (Tax Exempt)
Entity Type
Business or Organization
Organization Factors
(blank)
Profit Structure
Non-Profit Organization
Last updated by Amanda Webster on Jan 14, 2025 at 10:56 AM MARIPOSA COMMUNITY HEALTH CENTER, INC.
Mar 21, 2025 10:12:28 PM GMT https://sam.gov/entity/T7KJKFWEKNR9/coreData?status=null Page 1 of 2
Socio-Economic Types
Check the registrant's Reps & Certs, if present, under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA-certified HUBZone small business concern. Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the
SBA supplemental pages during registration.
Financial Information
Accepts Credit Card Payments
Yes
Debt Subject To Offset
No
EFT Indicator
CAGE Code
3LPV8
Points of Contact
Electronic Business
Dan Prevost, CEO 825 N Grand AVE STE 100
Nogales, Arizona 85621
United States
Jonathan Beltran, Project Manager 825 N Grand AVE STE 100
Nogales, Arizona 85621
United States
Government Business
Dan Prevost, CEO 825 N Grand AVE STE 100
Nogales, Arizona 85621
United States
Tia Duncan, COA 825 N Grand AVE STE 100
Nogales, Arizona 85621
United States
Past Performance
Jonathan Beltran, Project Manager 825 N Grand AVE STE 100
Nogales, Arizona 85621
United States
Humberto Duran 1852 N. Mastick WAY
Nogales, Arizona 85621
United States
Service Classifications
NAICS Codes
Primary
Yes
NAICS Codes
621498
NAICS Title
All Other Outpatient Care Centers
Disaster Response
This entity does not appear in the disaster response registry.
Last updated by Amanda Webster on Jan 14, 2025 at 10:56 AM MARIPOSA COMMUNITY HEALTH CENTER, INC.
Mar 21, 2025 10:12:28 PM GMT https://sam.gov/entity/T7KJKFWEKNR9/coreData?status=null Page 2 of 2
ENTITY INFORMATION
Search Date and Time: 3/21/2025 4:25:22 PM
Entity Details
Entity Name:
MARIPOSA COMMUNITY HEALTH CENTER, INC.
Entity ID:
01773351
Entity Type:
Domestic Nonprofit Corporation
Entity Status:
Active
Formation Date:
7/22/1985
Reason for Status:
In Good Standing
Approval Date:
7/25/1985
Status Date:
Original Incorporation Date:
7/22/1985
Life Period:
Perpetual
Business Type:
Health Care and Social Assistance
Last Annual Report Filed:
Domicile State:
Arizona
Annual Report Due Date:
9/22/2025
Years Due:
Original Publish Date:Privacy Policy (http://azcc.gov/privacy-policy) ǀ Contact Us (http://azcc.gov/corporations/corporation-contacts)
3/21/25, 4:25 PM Arizona Corporation Commission https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01773351 1/3 http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/corporations/corporation-contacts http://azcc.gov/corporations/corporation-contacts
Title Name Attention Address Date of Taking
Office
Last
Updated
CEO (Chief Executive Officer)
Dan Prevost 825 N. Grand Avenue, Suite
100, NOGALES, AZ, 85621,
Santa Cruz County, USA
10/26/2022 2/6/2023
Director
JUDITH
CLAREMON
825 N. Grand Avenue, Suite
100, NOGALES, AZ, 85621,
Santa Cruz County, USA
8/5/2005 9/21/2018
Director LOU JEONG 825 N. Grand Avenue, Suite
100, NOGALES, AZ, 85621,
Santa Cruz County, USA
8/16/2001 9/17/2021
Director RUDY PINA 825 N. Grand Avenue, Suite
100, NOGALES, AZ, 85621,
Santa Cruz County, USA
2/28/1988 9/21/2018
8/26/1985
Statutory Agent Information
Name:
Amy Taylor
Appointed Status:
Active 3/4/2025
Attention:
Address:
825 N Grand Ave, Suite 100, NOGALES, AZ 85621, USA
Agent Last Updated:
3/4/2025
E-mail:
Attention:
Mailing Address:
County:
Santa Cruz
Principal Information
Privacy Policy (http://azcc.gov/privacy-policy) ǀ Contact Us (http://azcc.gov/corporations/corporation-contacts)
3/21/25, 4:25 PM Arizona Corporation Commission https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01773351 2/3 http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/corporations/corporation-contacts
< Previous ... 1 2 3 ... Next > Page 1 of 3, records 1 to 5 of 13 Go to Page
Title Name Attention Address Date of Taking
Office
Last
Updated
Director
ROBERT
LINEIRO
825 N. Grand Avenue, Suite
100, NOGALES, AZ, 85621,
Santa Cruz County, USA
4/12/2017 9/17/2021
Back Return to Search
Return to Results
Document History Name/Restructuring History
Pending Documents Microfilm History
Address
Attention: Amy Taylor
Address: 825 N Grand Ave., NOGALES, AZ, 85621, USA
County: Santa Cruz
Last Updated: 9/23/2024
Entity Principal Office Address
Attention:
Address:
County:
Last Updated:
Privacy Policy (http://azcc.gov/privacy-policy) ǀ Contact Us (http://azcc.gov/corporations/corporation-contacts)
3/21/25, 4:25 PM Arizona Corporation Commission https://ecorp.azcc.gov/BusinessSearch/BusinessInfo?entityNumber=01773351 3/3 javascript:$xhtml.paging(2) javascript:$xhtml.paging(3) javascript:$xhtml.paging(2) http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/privacy-policy http://azcc.gov/corporations/corporation-contacts
Visit our tips page to learn how to best use the Exclusions Database. If you experience technical difficulties, please email the webmaster at webmaster@oig.hhs.gov.
Exclusions Search Results: Exclusions Search Results: EntitiesEntities
No Results were found for
Mariposa Community Health Center Inc
If no results are found, this individual or entity (if it is an entity search) is not currently excluded. Print this Web page for your documentation
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Search conducted 3/21/2025 7:23:02 PM EST on OIG LEIE Exclusions database.
Source data updated on 3/10/2025 10:01:00 AM EST
Return to Search
An official website of the United States government. Here's how you know >
3/21/25, 4:23 PM OIG Search Results https://exclusions.oig.hhs.gov/SearchResults.aspx 1/1 https://oig.hhs.gov/exclusions/exclusions-help.asp#generalSearch mailto:webmaster@oig.hhs.gov https://oig.hhs.gov/exclusions/exclusions-help.asp#entitySearch https://oig.hhs.gov/exclusions/exclusions-help.asp#entitySearch javascript:__doPostBack('ctl00$cpExclusions$lbGridBackToSearch','') javascript:__doPostBack('ctl00$cpExclusions$lbBackToSearch','') https://oig.hhs.gov/notices/official-site.asp
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Debarred and Suspended Firms SPO is responsible for maintaining a list of firms that are suspended or debarred from doing business with the State of Arizona.
THERE ARE NO SUSPENDED OR DEBARRED FIRMS AT THIS TIME.
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Agency Procurement Authority (/compliance/agency-procurement-authority)
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