OrganizationState Of New Mexico-AltsdCase Manager/Care CoordinatorOther Service ProvidersPractice Address2550 Cerrillos Road, Santa Fe, NM 87505(505) 476-4577PECOS EnrollmentBased on the most recent information from CMS, provider State Of New Mexico-Altsd does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1376089672Provider TypeOrganizationFull NameState Of New Mexico-AltsdSubpartNoEnumeration Date1/10/2017Last Updated1/10/2017Contact InformationPractice LocationPractice Address2550 Cerrillos Road, Santa Fe, NM 87505Phone(505) 476-4577FaxUnlisted FaxMailing LocationMailing Address2550 Cerrillos Rd, Santa Fe, NM 87505-3260Phone(505) 476-4577FaxUnlisted FaxAuthorized OfficialNameMoya, Carlos L (Division Director)Phone(505) 476-4577Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer