Jesus Acosta
Individual provider Active NPI Case Manager/Care Coordinator · Clovis, NM
NPI 1649676826 · NPPES record last updated Nov 14, 2014
Key facts
- NPI
- 1649676826
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 121 Townsgate PLZ
Clovis, NM 88101-3714 - Phone
- (575) 742-2620
- Fax
- (575) 742-3182
- NPI assigned
- Nov 14, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
121 Townsgate PLZ
Clovis, NM 88101-3714
Mailing address
202 E Earll Dr
Phoenix, AZ 85012-2634
Phone (575) 742-2620
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All providers in Clovis, NM · Case Manager/Care Coordinator in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.