MEDICARE: EXCELACARE HOSPICE OF NEW MEXICO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1528923190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELACARE HOSPICE OF NEW MEXICO LLC

Provider Business Mailing Address
First Line	:	101 W RENNER RD STE 420
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-2022
Country	:	US
Telephone Number	:	575-763-9728
Fax Number	:	575-762-2611

Provider Business Practice Location Address
First Line	:	101 W RENNER RD STE 420
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-2022
Country	:	US
Telephone Number	:	575-763-9728
Fax Number	:	575-762-2611

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	DONNIE MABERRY
Credential	:
Telephone Number	:	972-468-8070

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	01/30/2026

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