Healthcare Provider Details

I. General information

NPI: 1922017250
Provider Name (Legal Business Name): A NEW VISION CASE MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 CORRALES RD SUITE 105
CORRALES NM
87048-9348
US

IV. Provider business mailing address

PO BOX 56665
ALBUQUERQUE NM
87187-6665
US

V. Phone/Fax

Practice location:
  • Phone: 505-890-8545
  • Fax: 505-890-6754
Mailing address:
  • Phone: 505-890-8545
  • Fax: 505-890-6754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2006-862
License Number StateNM

VIII. Authorized Official

Name: PATRICIA POSEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 505-890-8545