Provider Demographics
NPI:1144360462
Name:EXCEL CASE MANAGEMENT, INC.
Entity type:Organization
Organization Name:EXCEL CASE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-324-8660
Mailing Address - Street 1:PO BOX 2839
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-2839
Mailing Address - Country:US
Mailing Address - Phone:505-324-8660
Mailing Address - Fax:505-564-2585
Practice Address - Street 1:300 W ARRINGTON ST
Practice Address - Street 2:STE 106
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-8436
Practice Address - Country:US
Practice Address - Phone:505-324-8660
Practice Address - Fax:505-564-2585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD3826Medicaid