Provider Demographics
NPI:1225531627
Name:VELEZ CASE MANAGEMENT
Entity Type:Organization
Organization Name:VELEZ CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENT CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:505-862-3109
Mailing Address - Street 1:3506 CAMINO DE LOS CABALLOS
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-6892
Mailing Address - Country:US
Mailing Address - Phone:505-862-3109
Mailing Address - Fax:
Practice Address - Street 1:3506 CAMINO DE LOS CABALLOS
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-6892
Practice Address - Country:US
Practice Address - Phone:505-862-3109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM14221756Medicaid