Healthcare Provider Details

I. General information

NPI: 1922517606
Provider Name (Legal Business Name): NEWMEX CASE MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 S LEA AVE
ROSWELL NM
88203-4567
US

IV. Provider business mailing address

607 S LEA AVE
ROSWELL NM
88203-4567
US

V. Phone/Fax

Practice location:
  • Phone: 575-420-9541
  • Fax:
Mailing address:
  • Phone: 575-420-9541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: ANGELA CHAVEZ
Title or Position: CEO
Credential:
Phone: 575-420-9541