ContractProvider Agreement • October 11th, 2022 • New Mexico
Contract Type FiledOctober 11th, 2022 JurisdictionThis Provider Agreement is entered into by and between the DEPARTMENT OF HEALTH, hereinafter referred to as the "DEPARTMENT", and Name of Provider, hereinafter referred to as the "PROVIDER".
ContractProvider Agreement • July 26th, 2022 • New Mexico
Contract Type FiledJuly 26th, 2022 JurisdictionThis Provider Agreement is entered into by and between the DEPARTMENT OF HEALTH, hereinafter referred to as the "DEPARTMENT", and Name of Provider, hereinafter referred to as the "PROVIDER".
ContractProvider Agreement • March 23rd, 2020 • New Mexico
Contract Type FiledMarch 23rd, 2020 JurisdictionThis Provider Agreement is entered into by and between the DEPARTMENT OF HEALTH, hereinafter referred to as the "DEPARTMENT", and PROVIDER NAME, hereinafter referred to as the "PROVIDER".
TERM OF PROVIDER AGREEMENTProvider Agreement • November 7th, 2014 • New Mexico
Contract Type FiledNovember 7th, 2014 JurisdictionThis Provider Agreement serves as a binding agreement between the DEPARTMENT and the PROVIDER to serve persons eligible for Medicaid reimbursed services through the Mi Via program as specified in the PROVIDER’S Service Summary Report Attachment A, The term of this Provider Agreement is effective
TERM OF PROVIDER AGREEMENTProvider Agreement • January 17th, 2013 • New Mexico
Contract Type FiledJanuary 17th, 2013 JurisdictionThis Provider Agreement serves as a binding agreement between the DEPARTMENT and the PROVIDER to serve persons eligible for Medicaid reimbursed services through the Medically Fragile (MF) and/or Developmental Disabilities (DD) Medicaid Waiver programs as specified in the PROVIDER’S Service