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)CodeLicenseStatePrimary
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

Other providers in Clovis, NM

All providers in Clovis, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.