Provider Demographics
NPI:1144309741
Name:ZIMMERMAN CONSULTING, INC.
Entity type:Organization
Organization Name:ZIMMERMAN CONSULTING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-866-9271
Mailing Address - Street 1:15 JEMEZ DR.
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031
Mailing Address - Country:US
Mailing Address - Phone:505-866-9271
Mailing Address - Fax:505-866-9278
Practice Address - Street 1:79 ROMERO RD
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7624
Practice Address - Country:US
Practice Address - Phone:505-866-9271
Practice Address - Fax:505-866-9278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1098 & 1112322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM98902563Medicaid
NMNM600617OtherVALUE OPTIONS PROVIDER #