Provider Demographics
NPI:1285659003
Name:MESILLA VALLEY HOSPICE, INC
Entity Type:Organization
Organization Name:MESILLA VALLEY HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:505-525-5711
Mailing Address - Street 1:299 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3223
Mailing Address - Country:US
Mailing Address - Phone:505-523-4700
Mailing Address - Fax:505-525-5775
Practice Address - Street 1:299 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3223
Practice Address - Country:US
Practice Address - Phone:505-523-4700
Practice Address - Fax:505-525-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6139251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0H98OtherBCBS OF NEW MEXICO
NM21137OtherLOVELACE HEALTH PLAN
NM17334OtherPRESBYTERIAN HEALTH PLAN
NML0049Medicaid
NM17334OtherPRESBYTERIAN HEALTH PLAN
NML0049Medicaid