Provider Demographics
NPI:1083262778
Name:HEART OF NM CASE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:HEART OF NM CASE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-639-0200
Mailing Address - Street 1:225 E IDAHO AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3242
Mailing Address - Country:US
Mailing Address - Phone:575-288-1392
Mailing Address - Fax:575-587-7220
Practice Address - Street 1:225 E IDAHO AVE STE 20
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3242
Practice Address - Country:US
Practice Address - Phone:575-288-1392
Practice Address - Fax:575-587-7220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM5844282OtherNM BUSINESS ID NUMBER