Healthcare Provider Details

I. General information

NPI: 1952251092
Provider Name (Legal Business Name): EXCELACARE HOSPICE OF EASTERN NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N MAIN ST STE 19A
CLOVIS NM
88101-3575
US

IV. Provider business mailing address

101 W RENNER RD STE 420
RICHARDSON TX
75082-2022
US

V. Phone/Fax

Practice location:
  • Phone: 575-769-0049
  • Fax: 575-742-3368
Mailing address:
  • Phone: 877-525-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN BRANDON DURBIN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 469-361-0120