Healthcare Provider Details

I. General information

NPI: 1326136532
Provider Name (Legal Business Name): EL ROCKY MOUNTAIN MANAGEMENT & SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 RENCHER ST 316 WEST 7TH STREET
CLOVIS NM
88101-6560
US

IV. Provider business mailing address

PO BOX 582 712 RENCHER
CLOVIS NM
88102-0582
US

V. Phone/Fax

Practice location:
  • Phone: 505-763-5003
  • Fax: 505-762-2815
Mailing address:
  • Phone: 505-762-6091
  • Fax: 505-762-2815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. EUGENE D LOVATO
Title or Position: CEO/OWNER
Credential:
Phone: 505-762-6091